1
|
Fattal J, Brascamp JW, Slate RE, Lehet M, Achtyes ED, Thakkar KN. Blunted pupil light reflex is associated with negative symptoms and working memory in individuals with schizophrenia. Schizophr Res 2022; 248:254-262. [PMID: 36115190 PMCID: PMC9613610 DOI: 10.1016/j.schres.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 08/21/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
Two largely separate lines of research have documented altered pupillary dynamics in individuals diagnosed with schizophrenia. An older set of studies has demonstrated reductions in the pupillary light reflex (PLR) in individuals with schizophrenia; however, clinical and cognitive correlates of this blunted PLR have been relatively unexplored. More recently, a large body of work has demonstrated reductions in pupillary dilation in response to cognitive demands in individuals with schizophrenia, and the degree of this blunted pupil dilation has been related to more severe cognitive deficits and motivational negative symptoms. These clinically relevant alterations in the cognitive modulation of pupil size have been interpreted as reflecting insufficient information processing resources or inappropriate effort allocation. To begin to bridge these two lines of work, we investigated the PLR in 34 individuals with schizophrenia and 30 healthy controls and related the amplitude of the PLR to motivational negative symptoms and cognitive performance. Consistent with prior work, we found that the PLR was reduced in individuals with schizophrenia, and furthermore, that these measurements were highly reliable across individuals. Blunted constriction was associated with more severe motivational negative symptoms and poorer working memory among individuals with schizophrenia. These observed correlates provide a bridge between older literature documenting an altered PLR and more recent work reporting associations between negative symptoms, cognition, and blunted pupillary dilation in response to cognitive demands in individuals with schizophrenia. We provide possible mechanistic interpretations of our data and consider a parsimonious explanation for reduced cognitive- and light-related modulation of pupil size.
Collapse
Affiliation(s)
- Jessica Fattal
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Jan W Brascamp
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Rachael E Slate
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Matthew Lehet
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Eric D Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, United States of America; Cherry Health, Grand Rapids, MI, United States of America
| | - Katharine N Thakkar
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America; Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI, United States of America.
| |
Collapse
|
2
|
Kania BF, Wrońska D, Szpręgiel I, Bracha U. Glutamate as a Stressoric Factor for the Ex Vivo Release of Catecholamines from the Rabbit Medial Prefrontal Cortex (mPFC). Life (Basel) 2021; 11:1386. [PMID: 34947917 PMCID: PMC8703736 DOI: 10.3390/life11121386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
One of the major roles of glutamic acid (Glu) is to serve as an excitatory neurotransmitter within the central nervous system (CNS). This amino acid influences the activity of several brain areas, including the thalamus, brainstem, spinal cord, basal ganglia, and pons. Catecholamines (CAs) are synthesized in the brain and adrenal medulla and by some sympathetic nerve fibers. CAs, including dopamine (DA), norepinephrine (NE), and epinephrine (E), are the principal neurotransmitters that mediate a variety of CNS functions, such as motor control, cognition, emotion, memory processing, pain, stress, and endocrine modulation. This study aims to investigate the effects of the application of various Glu concentrates (5, 50, and 200 µM) on CAs release from rabbit medial prefrontal cortex (mPFC) slices and compare any resulting correlations with CAs released from the hypothalamus during 90 min of incubation. Medial prefrontal cortex samples were dissected from decapitated, twelve-week-old female rabbits. The results demonstrated that Glu differentially influences the direct release of CAs from the mPFC and the indirect release of CAs from the hypothalamus. When under stress, the hypothalamus, a central brain structure of the HPA axis, induces and adapts such processes. Generally, there was an inhibitory effect of Glu on CAs release from mPFC slices. Our findings show that the effect arises from Glu's action on higher-order motivational structures, which may indicate its contribution to the stress response by modulating the amount of CAs released.
Collapse
Affiliation(s)
- Bogdan Feliks Kania
- Veterinary Institute, University Center for Veterinary Medicine Jagiellonian University & Agriculture University, Hugon Kollataj Agricultural University in Cracow, 30-059 Krakow, Poland
| | - Danuta Wrońska
- Department of Physiology and Endocrinology of Animals, Faculty of Animal Sciences, Hugon Kollataj Agricultural University in Cracow, 30-059 Krakow, Poland; (D.W.); (I.S.)
| | - Izabela Szpręgiel
- Department of Physiology and Endocrinology of Animals, Faculty of Animal Sciences, Hugon Kollataj Agricultural University in Cracow, 30-059 Krakow, Poland; (D.W.); (I.S.)
| | - Urszula Bracha
- Center of Experimental and Innovative Medicine, Hugon Kollataj Agricultural University in Cracow, 30-248 Krakow, Poland;
| |
Collapse
|
3
|
Bodén R, Lindström L, Rautaharju P, Sundström J. Electrocardiographic signs of autonomic imbalance in medicated patients with first-episode schizophrenia spectrum disorders – relations to first treatment discontinuation and five-year remission status. Eur Psychiatry 2020; 27:213-8. [DOI: 10.1016/j.eurpsy.2010.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 11/16/2010] [Accepted: 12/08/2010] [Indexed: 10/18/2022] Open
Abstract
AbstractPurposeTo explore measures in electrocardiograms (ECG) influenced by autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent first antipsychotic pharmacotherapy discontinuation and five-year remission status.Subjects and methodsTwelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.ResultsPatients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy and with non-remission five years later.Discussion and conclusionIn this longitudinal cohort study, simple ECG measures influenced by autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. As this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.
Collapse
|
4
|
Ahuja S, Gupta RK, Damodharan D, Philip M, Venkatasubramanian G, Keshavan MS, Hegde S. Effect of music listening on P300 event-related potential in patients with schizophrenia: A pilot study. Schizophr Res 2020; 216:85-96. [PMID: 31924375 PMCID: PMC7613152 DOI: 10.1016/j.schres.2019.12.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 11/30/2019] [Accepted: 12/20/2019] [Indexed: 02/05/2023]
Abstract
Reduced amplitude and increased latency of P300 auditory event-related potential (ERP) in patients with schizophrenia (SZ) indicate impairment in attention. Overall arousal level can determine the amount of processing capacity required for attention allocation. Music evokes strong emotions and regulates arousability. Music has been used to modulate P300, especially in normals. This exploratory study examined the effect of music listening on the amplitude and latency of P300 in SZ patients. EEG/ERP was recorded (32-channels) while SZ patients (n = 20; 18-45 years) performed an auditory oddball P300 task after the eyes-closed rest condition (Condition-A) and ten-minute music listening condition (Condition-B) as per the complete counterbalancing design (AB-BA). Patients listened to the researcher chosen, instrumental presentation of raag-Bhoopali in the North-Indian-Classical-Music, for ten-minutes. All patients rated the music excerpt as a relaxing and positively valenced. A significant increase in accuracy score and reaction time during the oddball task after music listening was noted. There was an increase in amplitude at TP7. A trend of increased amplitude was noted across all electrodes in the music condition compared to the rest condition. Mean amplitude in an apriori defined time window of interest (250 to 750 ms) showed significant changes in the frontal and central electrode sites. Power spectral analysis indicated a slight increase in frontal and central alpha and theta activity during music listening. However, this was not statistically significant. Findings add further impetus to examine the effect of music in chronic psychiatric conditions. Need for systematic studies on a larger cohort is underscored.
Collapse
Affiliation(s)
- Shikha Ahuja
- Clinical Neuropsychology & Cognitive Neuroscience Centre and Music Cognition Laboratory, Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, KA, India
| | - Rajnish Kumar Gupta
- Clinical Neuropsychology & Cognitive Neuroscience Centre, Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, KA, India
| | - Dinakaran Damodharan
- Translational Psychiatry Laboratory, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, KA, India
| | - Mariamma Philip
- Department of Biostatistics, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, KA, India
| | - Ganesan Venkatasubramanian
- Translational Psychiatry Laboratory, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, KA, India
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center Massachusetts Mental Health Center, Harvard Medical School, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Shantala Hegde
- Clinical Neuropsychology & Cognitive Neuroscience Centre and Music Cognition Laboratory, Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, KA, India.
| |
Collapse
|
5
|
Khoury JM, Couto LFSC, Santos DDA, E Silva VHDO, Drumond JPS, Silva LLDCE, Malloy-Diniz L, Albuquerque MR, das Neves MDCL, Duarte Garcia F. Bad Choices Make Good Stories: The Impaired Decision-Making Process and Skin Conductance Response in Subjects With Smartphone Addiction. Front Psychiatry 2019; 10:73. [PMID: 30853918 PMCID: PMC6395375 DOI: 10.3389/fpsyt.2019.00073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 01/31/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction: Smartphone Addiction (SA) has caused negative consequences and functional impairments in college students, such as reduction of academic performance and impairment in sleep quality. Studies have shown that individuals with chemical and behavioral dependencies have a bias in decision-making process, which leads to short-term advantageous choices even if they cause long-term harm. This bias in decision-making process is accompanied by a change in somatic markers and is associated with the development and maintenance of addictive behavior. The decision-making process and the measurement of physiological parameters have not yet been analyzed in SA. The neuropsychological and physiological characterization of the SA can contribute to its approach with the other dependency syndromes and to its recognition as a disease. Objective: we aimed to evaluate the decision-making process under risk and under ambiguity in individuals with SA and to measure the physiological parameters that accompany this process. Method: We compared the performance in the Iowa Gambling Task (IGT), Game of Dice Task (GDT) and skin conductance response (SCR) between 50 individuals with SA and 50 controls. Results: Smartphone dependents presented a profile of impairment in decision-making under ambiguity, without impairment in decision-making under risk. They demonstrated lower SCR before disadvantageous choices, higher SCR after rewards and lower SCR after punishments during decision-making, which suggests difficulty in recognizing disadvantageous alternatives, high sensitivity to rewards, and low sensitivity to punishments. Conclusion: The impairment in the decision-making process in smartphone dependents is similar to that found in other chemical and behavioral addictions, such as alcohol addiction, gambling disorders and pathological buy. The impairment in decision under ambiguity with preservation of decision under risk may reflect dysfunction of implicit emotional processes without dysfunction of explicit cognitive process. This profile can contribute to the recognition of SA as a behavioral dependence and to guide specific preventive and therapeutic strategies.
Collapse
Affiliation(s)
- Julia Machado Khoury
- Department of Mental Health, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,Department of Clinical Medicine, Faculty of Health and Human Ecology, Belo Horizonte, Brazil.,Post-Graduation Program in Molecular Medicine (Pós-Graduação em Medicina Molecular), School of Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil
| | - Luiz Filipe Silva Codorino Couto
- Department of Mental Health, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil
| | - Douglas de Almeida Santos
- Department of Mental Health, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil
| | - Vitor Hugo de Oliveira E Silva
- Department of Mental Health, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil
| | | | | | - Leandro Malloy-Diniz
- Department of Mental Health, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,Post-Graduation Program in Molecular Medicine (Pós-Graduação em Medicina Molecular), School of Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil
| | - Maicon Rodrigues Albuquerque
- Post-Graduation Program in Molecular Medicine (Pós-Graduação em Medicina Molecular), School of Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,Department of Sports, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,INCT of Molecular Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil
| | - Maila de Castro Lourenço das Neves
- Department of Mental Health, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,Post-Graduation Program in Molecular Medicine (Pós-Graduação em Medicina Molecular), School of Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,INCT of Molecular Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil
| | - Frederico Duarte Garcia
- Department of Mental Health, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,Post-Graduation Program in Molecular Medicine (Pós-Graduação em Medicina Molecular), School of Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,INCT of Molecular Medicine, Universidade Federal de Minas Gerais–UFMG (Federal University of Minas Gerais), Belo Horizonte, Brazil.,Unité Inserm U1073, Rouen, France
| |
Collapse
|
6
|
Kimhy D, Wall MM, Hansen MC, Vakhrusheva J, Choi CJ, Delespaul P, Tarrier N, Sloan RP, Malaspina D. Autonomic Regulation and Auditory Hallucinations in Individuals With Schizophrenia: An Experience Sampling Study. Schizophr Bull 2017; 43:754-763. [PMID: 28177507 PMCID: PMC5472124 DOI: 10.1093/schbul/sbw219] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Auditory Hallucinations (AH) cause substantial suffering and dysfunction, yet remain poorly understood and modeled. Previous reports have linked AH to increases in negative emotions, suggesting a role for the autonomic nervous system (ANS) in underlying this link. Employing an Experience Sampling Method (ESM) approach, 40 individuals with schizophrenia completed a 36-hour ambulatory assessment of AH and cardiac autonomic regulation. Participants carried mobile electronic devices that prompted them to report 10 times/d the severity of their momentary AH, along with a Holter monitor that continuously recorded their cardiac autonomic regulation. The clocks of the devices and monitors were synchronized, allowing for high time-resolution temporal linking of the AH and concurrent autonomic data. Power spectral analysis was used to determine the relative vagal (parasympathetic) contribution to autonomic regulation during 5 minutes prior to each experience sample. The participants also completed interview-based measures of AH (SAPS; PSYRATS). The ESM-measured severity of AH was significantly correlated with the overall SAPS-indexed AH severity, along with the PSYRATS-indexed AH frequency, duration, loudness, degree of negative content, and associated distress. A mixed-effect regression model indicated that momentary increases in autonomic arousal, characterized by decreases in vagal input, significantly predicted increases in ESM-measured AH severity. Vagal input averaged over the 36-hour assessment displayed a small but significant inverse correlation with the SAPS-indexed AH. The results provide preliminary support for a link between ANS regulation and AH. The findings also underscore the highly dynamic nature of AH and the need to utilize high time-resolution methodologies to investigate AH.
Collapse
Affiliation(s)
- David Kimhy
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Melanie M. Wall
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | | | | | - C. Jean Choi
- New York State Psychiatric Institute, New York, NY
| | - Philippe Delespaul
- Departments of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Nicholas Tarrier
- Department of Psychology, University of Manchester, Manchester, UK
| | - Richard P. Sloan
- Department of Psychiatry, Columbia University, New York, NY;,New York State Psychiatric Institute, New York, NY
| | - Dolores Malaspina
- Department of Psychiatry & Child Psychiatry, New York University Medical Center, New York, NY
| |
Collapse
|
7
|
Dewe H, Watson DG, Braithwaite JJ. Uncomfortably numb: new evidence for suppressed emotional reactivity in response to body-threats in those predisposed to sub-clinical dissociative experiences. Cogn Neuropsychiatry 2016; 21:377-401. [PMID: 27466978 DOI: 10.1080/13546805.2016.1212703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Depersonalisation and derealisation disorders refer to feelings of detachment and dissociation from one's "self" or surroundings. A reduced sense of self (or "presence") and emotional "numbness" is thought to be mediated by aberrant emotional processing due to biases in self-referent multi-sensory integration. This emotional "numbing" is often accompanied by suppressed autonomic arousal to emotionally salient stimuli. METHODS 118 participants completed the Cambridge Depersonalisation scale [Sierra, & Berrios, 2000. The Cambridge Depersonalisation Scale: A new instrument for the measurement of depersonalisation. Psychiatry Research, 93, 153-164)] as an index of dissociative anomalous experience. Participants took part in a novel "Implied Body-Threat Illusion" task; a pantomimed injection procedure conducted directly onto their real body (hand). Objective psychophysiological data were recorded via standardised threat-related skin conductance responses and finger temperature measures. RESULTS Individuals predisposed to depersonalisation/derealisation revealed suppressed skin conductance responses towards the pantomimed body-threat. Although the task revealed a reliable reduction in finger temperature as a fear response, this reduction was not reliably associated with measures of dissociative experience. CONCLUSIONS The present findings significantly extend previous research by revealing emotional suppression via a more direct body-threat task, even for sub-clinical groups. The findings are discussed within probabilistic and predictive coding frameworks of multi-sensory integration underlying a coherent sense of self.
Collapse
Affiliation(s)
- Hayley Dewe
- a Behavioural Brain Sciences Centre , School of Psychology, University of Birmingham , Edgbaston , Birmingham , UK
| | - Derrick G Watson
- b Department of Psychology , University of Warwick , Coventry , UK
| | | |
Collapse
|
8
|
Davydov DM, Shapiro D. Single and Combined Effects of Sympathetic and Parasympathetic Activity on Perceptual Sensitivity and Attention. ACTA ACUST UNITED AC 2014. [DOI: 10.2753/rpo1061-0405370168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
9
|
Nilsson BM, Holm G, Hultman CM, Ekselius L. Cognition and autonomic function in schizophrenia: inferior cognitive test performance in electrodermal and niacin skin flush non-responders. Eur Psychiatry 2014; 30:8-13. [PMID: 25169443 DOI: 10.1016/j.eurpsy.2014.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 06/13/2014] [Accepted: 06/29/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Patients with schizophrenia suffer from a broad range of cognitive disturbances. The impact in terms of functional outcome is significant. There are also several reports of disturbed autonomic regulation in the disease. The present study examined cognitive function as well as psychophysiological parameters in patients with schizophrenia and healthy controls. METHODS Twenty-five patients and 14 controls were investigated with electrodermal activity (EDA), an oral niacin skin flush test and a comprehensive neurocognitive test program including the Wechsler battery (WAIS-R), Fingertapping Test, Trail Making Test, Verbal Fluency, Benton Visual Retention Test, Wisconsin Card Sorting Test and Rey Auditory Verbal Learning Test. RESULTS The patients generally had inferior test results compared to controls. Further analysis revealed that the EDA non-responding patient group explained this variation with significant lower test results than controls. On executive tests, EDA non-responders also performed significantly worse than EDA responding patients. The small group of niacin non-responding patients exhibited an even lower overall test performance. Delayed niacin flush also correlated inversely with psychomotor function and IQ in the patients. CONCLUSION The findings support the hypothesis of a neurodevelopment disturbance affecting both autonomic function and higher cortical function in schizophrenia.
Collapse
Affiliation(s)
- B M Nilsson
- Department of Neuroscience, Psychiatry, Uppsala University, SE-751 85 Uppsala, Sweden.
| | - G Holm
- Department of Neuroscience, Psychiatry, Uppsala University, SE-751 85 Uppsala, Sweden
| | - C M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, SE-17177 Stockholm, Sweden
| | - L Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, SE-751 85 Uppsala, Sweden
| |
Collapse
|
10
|
Remington G, Foussias G, Agid O, Fervaha G, Takeuchi H, Hahn M. The neurobiology of relapse in schizophrenia. Schizophr Res 2014; 152:381-90. [PMID: 24206930 DOI: 10.1016/j.schres.2013.10.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 10/06/2013] [Accepted: 10/08/2013] [Indexed: 12/30/2022]
Abstract
Dopamine's proposed role in psychosis proved a starting point in our understanding of the neurobiology of relapse, fitting given the central role positive symptoms play. This link is reflected in early work examining neurotransmitter metabolite and drug (e.g. amphetamine, methylphenidate) challenge studies as a means of better understanding relapse and predictors. Since, lines of investigation have expanded (e.g. electrophysiological, immunological, hormonal, stress), an important step forward if relapse per se is the question. Arguably, perturbations in dopamine represent the final common pathway in psychosis but it is evident that, like schizophrenia, relapse is heterogeneous and multidimensional. In understanding the neurobiology of relapse, greater gains are likely to be made if these distinctions are acknowledged; for example, efforts to identify trait markers might better be served by distinguishing primary (i.e. idiopathic) and secondary (e.g. substance abuse, medication nonadherence) forms of relapse. Similarly, it has been suggested that relapse is 'neurotoxic', yet individuals do very well on clozapine after multiple relapses and the designation of treatment resistance. An alternative explanation holds that schizophrenia is characterized by different trajectories, at least to some extent biologically and/or structurally distinguishable from the outset, with differential patterns of response and relapse. Just as with schizophrenia, it seems naïve to conceptualize the neurobiology of relapse as a singular process. We propose that it is shaped by the form of illness and in place from the outset, modified by constitutional factors like resilience, as well as treatment, and confounded by secondary forms of relapse.
Collapse
Affiliation(s)
- Gary Remington
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada.
| | - George Foussias
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Ofer Agid
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Gagan Fervaha
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Hiroyoshi Takeuchi
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Margaret Hahn
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| |
Collapse
|
11
|
Hoskin R, Hunter MD, Woodruff PWR. The effect of psychological stress and expectation on auditory perception: A signal detection analysis. Br J Psychol 2013; 105:524-46. [PMID: 25280122 DOI: 10.1111/bjop.12048] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/18/2013] [Indexed: 11/26/2022]
Abstract
Both psychological stress and predictive signals relating to expected sensory input are believed to influence perception, an influence which, when disrupted, may contribute to the generation of auditory hallucinations. The effect of stress and semantic expectation on auditory perception was therefore examined in healthy participants using an auditory signal detection task requiring the detection of speech from within white noise. Trait anxiety was found to predict the extent to which stress influenced response bias, resulting in more anxious participants adopting a more liberal criterion, and therefore experiencing more false positives, when under stress. While semantic expectation was found to increase sensitivity, its presence also generated a shift in response bias towards reporting a signal, suggesting that the erroneous perception of speech became more likely. These findings provide a potential cognitive mechanism that may explain the impact of stress on hallucination-proneness, by suggesting that stress has the tendency to alter response bias in highly anxious individuals. These results also provide support for the idea that top-down processes such as those relating to semantic expectation may contribute to the generation of auditory hallucinations.
Collapse
Affiliation(s)
- Robert Hoskin
- Sheffield Cognition and Neuroimaging Lab (SCANLAB), Academic Clinical Psychiatry, Department of Neuroscience, Faculty of Medicine, Dentistry & Health, Longley Centre, University of Sheffield, UK
| | | | | |
Collapse
|
12
|
Ikezawa S, Corbera S, Liu J, Wexler BE. Empathy in electrodermal responsive and nonresponsive patients with schizophrenia. Schizophr Res 2012; 142:71-6. [PMID: 23058162 PMCID: PMC3502678 DOI: 10.1016/j.schres.2012.09.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 09/20/2012] [Accepted: 09/21/2012] [Indexed: 11/18/2022]
Abstract
Skin conductance response (SCR) to emotion-evoking stimuli has in previous studies suggested the existence of two subgroups of schizophrenia patients. One is characterized by absent SCR and the other by heightened or non-habituating SCR. These subgroups have also been shown to differ in symptoms, prognosis and social integration. The present project compared social cognition in the two subgroups. SCR from 28 patients with schizophrenia and 24 matched healthy controls was measured while they watched emotion-evoking and neutral video tapes. Assessments of symptoms, neurocognition, social cognition, and social function were also performed. Event related potentials (ERP) were recorded in response to pictures of people experiencing pain or not. Subjects were divided into "SCR non-responder" and "SCR responder" groups based on SCR frequency. Schizophrenia SCR responders had significantly higher self-reported personal distress in response to others in distress and lower P300 ERP responses to others in pain than schizophrenia SCR non-responders and healthy controls. SCR responsiveness is a potential marker of subgroups of patients with schizophrenia that differ in pathophysiology, function and prognosis.
Collapse
Affiliation(s)
- Satoru Ikezawa
- Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- Division of Neuropsychiatry, Yowa Hospital, Yonago, Tottori, Japan
- Corresponding Author, Satoru Ikezawa, M.D., Ph.D., Connecticut Mental Health Center, 5th Floor, 34 Park Street, New Haven, CT 06519, Telephone: 1-203-974-7505,
| | - Silvia Corbera
- Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT
| | - Jiacheng Liu
- Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Bruce E. Wexler
- Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| |
Collapse
|
13
|
Subotnik KL, Schell AM, Chilingar MS, Dawson ME, Ventura J, Kelly KA, Hellemann GS, Nuechterlein KH. The interaction of electrodermal activity and expressed emotion in predicting symptoms in recent-onset schizophrenia. Psychophysiology 2012; 49:1035-8. [PMID: 22680838 DOI: 10.1111/j.1469-8986.2012.01383.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 02/23/2012] [Indexed: 11/29/2022]
Abstract
In the present study, expressed emotion (EE) was assessed among immediate family members of 94 recent-onset schizophrenia patients at initial study entry point, and patients' electrodermal activity (EDA) was measured without the presence of family members at a baseline outpatient stabilization assessment. Psychiatric symptoms were also rated, both at the baseline outpatient test and at 1-year follow-up. Electrodermal activity × expressed emotion interactions were observed at both test points. In each case, the highest levels of negative symptoms were observed among those who exhibited greater EDA and lived in a high-EE environment. These results support the view that the combination of high family EE and sympathetic nervous system arousal confer especially high risk for poor negative symptom outcomes.
Collapse
Affiliation(s)
- Kenneth L Subotnik
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles 90095-8346, USA.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
A developmental increase in allostatic load from ages 3 to 11 years is associated with increased schizotypal personality at age 23 years. Dev Psychopathol 2012; 23:1059-68. [PMID: 22018081 DOI: 10.1017/s0954579411000496] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Although allostatic load has been investigated in mood and anxiety disorders, no prior study has investigated developmental change in allostatic load as a precursor to schizotypal personality. This study employed a multilevel developmental framework to examine whether the development of increased allostatic load, as indicated by impaired sympathetic nervous system habituation from ages 3 to 11 years, predisposes to schizotypal personality at age 23 years. Electrodermal activity to six aversive tones was recorded in 995 subjects at age 3 years and again at 11 years. Habituation slopes at both ages were used to create groups who showed a developmental increase in habituation (decreased allostatic load), and those who showed a developmental decrease in habituation (increased allostatic load). Children who showed a developmental increase in allostatic load from ages 3 to 11 years had higher levels of schizotypal personality at 23 years. A breakdown of total schizotypy scores demonstrated specificity of findings to cognitive-perceptual features of schizotypy. Findings are the first to document a developmental abnormality in allostasis in relation to adult schizotypal personality. The relative failure to develop normal habituation to repeated stressors throughout childhood is hypothesized to result in an accumulation of allostatic load and consequently increased positive symptom schizotypy in adulthood.
Collapse
|
15
|
Blessing E, Kader L, Arpandy R, Ootsuka Y, Blessing WW, Pantelis C. Atypical antipsychotics cause an acute increase in cutaneous hand blood flow in patients with schizophrenia and schizoaffective disorder. Aust N Z J Psychiatry 2011; 45:646-53. [PMID: 21870922 DOI: 10.3109/00048674.2011.587397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Clinical studies suggest resting thermoregulatory cutaneous vasomotor tone could be increased in schizophrenia, resulting in reduced hand blood flow. In animal models, atypical antipsychotics including clozapine potently inhibit sympathetic neural outflow to the thermoregulatory cutaneous vascular beds. We have now determined whether antipsychotic medication administration is associated with an acute increase in hand blood flow in patients with schizophrenia and schizoaffective disorder, and whether this increase correlates with clinical status. METHOD Hand temperature was measured with an infrared camera in 12 patients with chronic schizophrenia or schizoaffective disorder 30 min prior to, then 30 and 60 min following medication. Clinical status was assessed via the Brief Psychiatric Rating Scale (BPRS). Results were compared using regression and repeated measures analysis of variance. RESULTS A robust and significant increase in hand temperature (p < 0.001) was observed following antipsychotic administration. The mean increase after 60 min was 4.1 ± 2.4°C. This increase was significantly associated with colder hand temperature prior to medication (p < 0.05; suggestive of increased resting vasoconstriction) and with more severe psychiatric symptoms (p < 0.05). CONCLUSIONS Atypical antipsychotics were associated with increased hand blood flow, consistent with inhibition of thermoregulatory sympathetic outflow to the cutaneous vascular bed in patients with schizophrenia and schizoaffective disorder. This increase correlated with symptom severity. Hand temperature increase following antipsychotic medication may therefore be a simple and informative physiological marker of disease activity and potential response in patients with schizophreniform disorders. Given that antipsychotics also inhibit sympathetic outflow to brown adipose tissue, which normally converts energy to heat, future studies should examine whether antipsychotic-induced hand temperature increase is associated with antipsychotic-induced weight gain.
Collapse
Affiliation(s)
- Esther Blessing
- Department of Psychiatry, University of Melbourne, St. Vincent's Hospital, Fitzroy, Victoria 3065, Australia.
| | | | | | | | | | | |
Collapse
|
16
|
Hallak JEC, Machado-de-Sousa JP, Crippa JAS, Sanches RF, Trzesniak C, Chaves C, Bernardo SA, Regalo SC, Zuardi AW. Performance of schizophrenic patients in the Stroop Color Word Test and electrodermal responsiveness after acute administration of cannabidiol (CBD). BRAZILIAN JOURNAL OF PSYCHIATRY 2011; 32:56-61. [PMID: 20339735 DOI: 10.1590/s1516-44462010000100011] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 10/01/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The last decade has seen increasing evidence of dysfunctions in the endogenous cannabinoid system in schizophrenia and of its relationship with the typical cognitive impairment of the disorder. Studies in animal models, healthy volunteers, and psychotic patients clearly suggest an antipsychotic-like effect of cannabidiol. This study investigated the effects of cannabidiol on selective attention in 28 schizophrenic patients using the Stroop Color Word Test and on these patients' electrodermal responsiveness to auditive stimuli. METHOD The subjects attended two experimental sessions, the first one without the administration of drugs. In the second session the subjects were divided into three groups that received either a single dose of cannabidiol 300 mg or cannabidiol 600 mg or placebo. RESULTS The three groups did not differ significantly with respect to electrodermal measures in the two experimental sessions. When the first and second sessions were compared improved performance was found in all three groups, with patients who received placebo and cannabidiol 300 mg performing better than those who received cannabidiol 600 mg. CONCLUSION The single, acute administration of cannabidiol seems to have no beneficial effects on the performance of schizophrenic patients in the Stroop Color Word Test, although the hypothesis that chronic administration may lead to improvement cannot be disregarded.
Collapse
Affiliation(s)
- Jaime E C Hallak
- University Hospital of the Ribeirão Preto Medical School, Department of Neuroscience and Behavior, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Kéri S, Seres I, Kelemen O, Benedek G. The relationship among neuregulin 1-stimulated phosphorylation of AKT, psychosis proneness, and habituation of arousal in nonclinical individuals. Schizophr Bull 2011; 37:141-7. [PMID: 19549627 PMCID: PMC3004188 DOI: 10.1093/schbul/sbp063] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Previous studies reported an association between weak habituation of skin conductance orienting response and psychosis proneness. The aim of this study was to investigate the relationship among neuregulin 1 (NRG1)-stimulated AKT phosphorylation (a putative marker of psychosis), orienting response habituation, delusional ideas, anxiety, and depression in nonclinical individuals. METHODS One hundred twenty individuals participated in the skin conductance measurements. Weak and strong habituators were compared on measures of NRG1-stimulated AKT phosphorylation in B lymphoblasts, delusional ideas, anxiety, and depression. The predictors of delusional ideas were determined by multiple regression analysis. RESULTS Weak habituators displayed higher levels of delusional ideas/anxiety and a lower ratio of phosphorylated AKT as compared with strong habituators. There were 3 significant predictors of delusional ideas: decreased habituation, NRG1-induced AKT phosphorylation, and anxiety. Age, gender, education, IQ, and depression did not predict delusional ideas. CONCLUSIONS These results suggest that decreased habituation of arousal, NRG1-induced AKT phosphorylation, and anxiety are related to delusional ideation in the general population.
Collapse
Affiliation(s)
- Szabolcs Kéri
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa u. 6., Budapest H1083, Hungary.
| | - Imola Seres
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa u. 6., Budapest H1083, Hungary
| | - Oguz Kelemen
- Psychiatry Center, Bács-Kiskun County Hospital, Kecskemét, Hungary
| | - György Benedek
- Department of Physiology, University of Szeged, Szeged, Hungary
| |
Collapse
|
18
|
Dawson ME, Schell AM, Rissling A, Ventura J, Subotnik KL, Nuechterlein KH. Psychophysiological prodromal signs of schizophrenic relapse: a pilot study. Schizophr Res 2010; 123:64-7. [PMID: 20724111 PMCID: PMC4128618 DOI: 10.1016/j.schres.2010.07.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 07/22/2010] [Accepted: 07/26/2010] [Indexed: 10/19/2022]
Abstract
Do physiological changes occur shortly prior to psychotic relapse in schizophrenia outpatients? We addressed this question in a group of schizophrenia outpatients by measuring changes in symptoms and changes in activation of the sympathetic nervous system, as indexed by changes in skin conductance level (SCL), on a biweekly basis for between one and two years. All six outpatients exhibited heightened SCL within two weeks prior to relapse or exacerbation, compared to SCL proceeding continued remission. These results shed light on the psychotic relapse process and are consistent with neural diathesis-stress models of schizophrenia.
Collapse
Affiliation(s)
| | | | | | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Kenneth L. Subotnik
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles,Department of Psychology, University of California, Los Angeles
| |
Collapse
|
19
|
Rădulescu AR, Mujica-Parodi LR. A principal component network analysis of prefrontal-limbic functional magnetic resonance imaging time series in schizophrenia patients and healthy controls. Psychiatry Res 2009; 174:184-94. [PMID: 19880294 PMCID: PMC2788080 DOI: 10.1016/j.pscychresns.2009.04.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Revised: 04/29/2009] [Accepted: 04/29/2009] [Indexed: 10/20/2022]
Abstract
We investigated neural regulation of emotional arousal. We hypothesized that the interactions between the components of the prefrontal-limbic system determine the global trajectories of the individual's brain activation, with the strengths and modulations of these interactions being potentially key components underlying the differences between healthy individuals and those with schizophrenia. Using affect-valent facial stimuli presented to 11 medicated schizophrenia patients and 65 healthy controls, we activated neural regions associated with the emotional arousal response during functional magnetic resonance imaging (fMRI). Performing first a random effects analysis of the fMRI data to identify activated regions, we obtained 352 data-point time series for six brain regions: bilateral amygdala, hippocampus and two prefrontal regions (Brodmann Areas 9 and 45). Since standard statistical methods are not designed to capture system features and evolution, we used principal component analyses on two types of pre-processed data: contrasts and group averages. We captured an important characteristic of the evolution of our six-dimensional brain network: all subject trajectories are almost embedded in a two-dimensional plane. Moreover, the direction of the largest principal component was a significant differentiator between the control and patient populations: the left and right amygdala coefficients were substantially higher in the case of patients, and the coefficients of Brodmann Area 9 were, to a lesser extent, higher in controls. These results are evidence that modulations between the regions of interest are the important determinant factors for the system's dynamical behavior. We place our results within the context of other principal component analyses used in neuroimaging, as well as of our existing theoretical model of prefrontal-limbic dysregulation.
Collapse
Affiliation(s)
- Anca R Rădulescu
- Department of Applied Mathematics, UCB 526, University of Colorado at Boulder, Boulder, CO 80309-0526, USA.
| | | |
Collapse
|
20
|
Carpenter WT, Bustillo JR, Thaker GK, van Os J, Krueger RF, Green MJ. The psychoses: cluster 3 of the proposed meta-structure for DSM-V and ICD-11. Psychol Med 2009; 39:2025-2042. [PMID: 19796428 DOI: 10.1017/s0033291709990286] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In an effort to group mental disorders on the basis of etiology, five clusters have been proposed. Here we consider the validity of the cluster comprising selected psychotic and related disorders. METHOD A group of diagnostic entities classified under schizophrenia and other psychotic disorders in DSM-IV-TR were assigned to this cluster and the bordering disorders, bipolar (BD) and schizotypal personality disorders (SPD), were included. We then reviewed the literature in relation to 11 validating criteria proposed by the DSM-V Task Force Study Group. RESULTS Relevant comparisons on the 11 spectrum criteria are rare for the included disorders except for schizophrenia and the two border conditions, BD and SPD. The core psychosis group is congruent at the level of shared psychotic psychopathology and response to antipsychotic medication. BD and SPD are exceptions in that psychosis is not typical in BD-II disorder and frank psychosis is excluded in SPD. There is modest similarity between schizophrenia and BD relating to risk factors, neural substrates, cognition and endophenotypes, but key differences are noted. There is greater support for a spectrum relationship of SPD and schizophrenia. Antecedent temperament, an important validator for other groupings, has received little empirical study in the various psychotic disorders. CONCLUSIONS The DSM-IV-TR grouping of psychotic disorders is supported by tradition and shared psychopathology, but few data exist across these diagnoses relating to the 11 spectrum criteria. The case for including BD is modest, and the relationship of BD to other mood disorders is addressed elsewhere. Evidence is stronger for inclusion of SPD, but the relationship with other personality disorders along the 11 criteria is not addressed and the absence of psychosis presents a conceptual problem. There are no data along the 11 spectrum criteria that are decisive for a cluster based on etiology, and inclusion of BD and SPD is questionable.
Collapse
Affiliation(s)
- W T Carpenter
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA.
| | | | | | | | | | | |
Collapse
|
21
|
Nilsson BM, Hultman CM, Ekselius L. Test-retest stability of the oral niacin test and electrodermal activity in patients with schizophrenia. Prostaglandins Leukot Essent Fatty Acids 2009; 81:367-72. [PMID: 19864122 DOI: 10.1016/j.plefa.2009.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Revised: 09/04/2009] [Accepted: 09/21/2009] [Indexed: 10/20/2022]
Abstract
In schizophrenia, well-replicated findings support an attenuated niacin skin-flush response. We have previously reported a delayed skin-flush after niacin ingestion and also an association between niacin non-responding and electrodermal non-responding in schizophrenia. The stability of the niacin and electrodermal tests was now studied in a test-retest design. An additional aim was to assess the association previously found. Twenty-three patients with schizophrenia underwent two sessions 3 months apart during which an oral niacin test was conducted and electrodermal activity was measured. Despite similar values for niacin outcome variables at the group level, there was high intraindividual variation. Test-retest stability for the oral niacin test was thus low, although a trend toward correlation for the dichotomous response criterion was found. Most electrodermal measures correlated between baseline and retest. A significant association between the tests was again found; niacin non-responding implied electrodermal non-responding, providing further support for a common underlying aberration in schizophrenia.
Collapse
Affiliation(s)
- B M Nilsson
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala SE-75185, Sweden.
| | | | | |
Collapse
|
22
|
Beat-to-beat heart rate and QT interval variability in first episode neuroleptic-naive psychosis. Schizophr Res 2009; 113:176-80. [PMID: 19570654 PMCID: PMC2829670 DOI: 10.1016/j.schres.2009.06.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2009] [Revised: 06/02/2009] [Accepted: 06/03/2009] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Though increased risk of sudden death in patients with schizophrenia is well-documented, the mechanisms remain unclear. Recent studies report two known risk factors for sudden cardiac death and other arrhythmias in schizophrenia, i.e., decreased RR interval variability (RRV) and increased QT interval variability (QTV). However, these studies did not control for the effects of medication. Herein, we report the results of our study comparing RRV and QTV in first episode neuroleptic-naive psychosis patients with healthy matched controls. METHODS 24 patients with first episode neuroleptic naïve psychosis were matched with 26 healthy controls on age and gender. After an overnight fast, all participants underwent an electrocardiogram recording in the morning. RESULTS In comparison with matched controls, patients with first episode neuroleptic-naïve psychosis had significantly increased QTV corrected for RRV, and decreased RRV. CONCLUSIONS The observed alterations in RRV and QTV may reflect impaired cardiac autonomic function that could underlie risk for abnormal ventricular repolarization and thereby increase the risk of sudden death and other arrhythmias. Our data suggest that RRV and QTV alterations may be independent of medication effects in first episode psychosis patients.
Collapse
|
23
|
Falloon IRH, Barbieri L, Boggian I, Lamonaca D. Problem solving training for schizophrenia: Rationale and review. J Ment Health 2009. [DOI: 10.1080/09638230701494910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
24
|
Sanches R, Crippa J, Hallak J, de Sousa J, Araújo D, Santos A, Zuardi A. Proton magnetic resonance spectroscopy of the frontal, cingulate and perirolandic cortices and its relationship to skin conductance in patients with schizophrenia. Braz J Med Biol Res 2008; 41:1132-41. [DOI: 10.1590/s0100-879x2008001200015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Accepted: 12/04/2008] [Indexed: 11/21/2022] Open
|
25
|
Raˇdulescu A. Schizophrenia—a parameters’ game? J Theor Biol 2008; 254:89-98. [DOI: 10.1016/j.jtbi.2008.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 03/18/2008] [Accepted: 05/02/2008] [Indexed: 11/25/2022]
|
26
|
Dinzeo TJ, Cohen AS, Nienow TM, Docherty NM. Arousability in schizophrenia: relationship to emotional and physiological reactivity and symptom severity. Acta Psychiatr Scand 2008; 117:432-9. [PMID: 18397361 DOI: 10.1111/j.1600-0447.2008.01185.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Socioenvironmental stressors have been linked with increased symptom severity and relapse in those with schizophrenia. However, little is known about how individual differences in stress reactivity may contribute to these outcomes. METHOD This study examined the association between the temperament characteristic of arousability and changes in negative affect and cardiovascular activity during a challenge task in 58 in-patients with diagnosis of schizophrenia and 21 controls. RESULTS In the patient group, levels of arousability were significantly associated with increases in negative affect in response to the task and greater severity of affective symptoms. Levels of arousability were associated with decreased heart rate during the challenge task in our patient group. CONCLUSION These findings suggest that greater attention be given to individual differences, such as temperament and personality characteristics, and their role in the experience of stressors, including emotional and physiological response, as well as symptom development.
Collapse
Affiliation(s)
- T J Dinzeo
- Department of Psychology, Kent State University, Kent, OH, USA.
| | | | | | | |
Collapse
|
27
|
Castro MN, Vigo DE, Weidema H, Fahrer RD, Chu EM, de Achával D, Nogués M, Leiguarda RC, Cardinali DP, Guinjoan SM. Heart rate variability response to mental arithmetic stress in patients with schizophrenia: autonomic response to stress in schizophrenia. Schizophr Res 2008; 99:294-303. [PMID: 17913466 DOI: 10.1016/j.schres.2007.08.025] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 08/23/2007] [Accepted: 08/24/2007] [Indexed: 12/21/2022]
Abstract
BACKGROUND The vulnerability-stress hypothesis is an established model of schizophrenia symptom formation. We sought to characterise the pattern of the cardiac autonomic response to mental arithmetic stress in patients with stable schizophrenia. METHODS We performed heart rate variability (HRV) analysis on recordings obtained before, during, and after a standard test of autonomic function involving mental stress in 25 patients with DSM-IV schizophrenia (S) and 25 healthy individuals (C). RESULTS Patients with schizophrenia had a normal response to the mental arithmetic stress test. Relative contributions of low-frequency (LF) HRV and high-frequency (HF) HRV influences on heart rate in patients were similar to controls both at rest (LF 64+/-19% (S) vs. 56+/-16% (C); HF 36+/-19% (S) vs. 44+/-16% (C), t=1.52, p=0.136) and during mental stress, with increased LF (S: 76+/-12%, C: 74+/-11%) and decreased HF (S: 24+/-12%, C: 26+/-11%) in the latter study condition. Whilst healthy persons recovered the resting pattern of HRV immediately after stress termination (LF 60+/-15%, HF 40+/-15%, F=18.5, p<0.001), in patients HRV remained unchanged throughout the observed recovery period, with larger LF (71+/-17%) and lower HF (29+/-17%) compared with baseline (F=7.3, p=0.013). CONCLUSIONS Patients with schizophrenia exhibit a normal response to the mental arithmetic stress test as a standard test of autonomic function but in contrast with healthy individuals, they maintain stress-related changes of cardiac autonomic function beyond stimulus cessation.
Collapse
Affiliation(s)
- Mariana N Castro
- Department of Neurology, Fundación Lucha contra Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Schug RA, Raine A, Wilcox RR. Psychophysiological and behavioural characteristics of individuals comorbid for antisocial personality disorder and schizophrenia-spectrum personality disorder. Br J Psychiatry 2007; 191:408-14. [PMID: 17978320 DOI: 10.1192/bjp.bp.106.034801] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few studies have examined people with comorbid schizophrenia-spectrum personality disorder and antisocial personality disorder, a subgroup who may differ psychophysiologically and behaviourally from those with either condition alone. AIMS To test whether individuals with both types of personality disorder are particularly characterised by reduced orienting and arousal and by increased criminal offending. METHOD In a community adult sample, self-reported crime and skin conductance orienting were collected on four diagnostic groups: schizophrenia-spectrum personality disorder only; antisocial personality disorder only; comorbidity of the two disorders; and a control group. RESULTS The comorbid group showed significantly higher levels of criminal behaviour than the other three groups. They also showed reduced skin conductance orienting to neutral tones compared with the other groups, and significantly reduced arousal and orienting to significant stimuli compared with the control group. CONCLUSIONS Reduced orienting may reflect a neurocognitive attentional risk factor for both antisocial and schizotypal personality disorders that indirectly reflects a common neural substrate to these disorders.
Collapse
Affiliation(s)
- Robert A Schug
- Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
| | | | | |
Collapse
|
29
|
Crippa JA, Waldo Zuardi A, Trzesniak C, Hallak JEC, Busatto GF, McGuire PK. No association between electrodermal hyporesponsivity and enlarged cavum septi pellucidi in schizophrenia. Schizophr Res 2007; 95:256-8. [PMID: 17629675 DOI: 10.1016/j.schres.2007.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Revised: 05/31/2007] [Accepted: 06/06/2007] [Indexed: 11/26/2022]
|
30
|
Phillips LK, Voglmaier MM, Deldin PJ. A preliminary study of emotion processing interference in schizophrenia and schizoaffective disorder. Schizophr Res 2007; 94:207-14. [PMID: 17553673 DOI: 10.1016/j.schres.2007.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 04/02/2007] [Accepted: 04/05/2007] [Indexed: 11/26/2022]
Abstract
The impact of emotional arousal may be an equal or more important factor than valence in determining whether emotion interferes with language output in individuals with schizophrenia. An affective reactivity task, comprising conditions separated by emotional valence (positive, negative) and arousal (low, high), was administered to 22 individuals with schizophrenia or schizoaffective disorder and 13 non-patient controls. Individuals with schizophrenia or schizoaffective disorder demonstrated variable reactivity to both valence arousal. Results suggest that high arousal content can be especially impairing to certain individuals, and it is those individuals with schizophrenia and schizoaffective disorder who demonstrate more depressive symptomatology that show the greatest affective reactivity to negatively valenced, high arousing information. Clarifying aberrant emotion processing in schizophrenia is crucial to understanding precursors to symptom exacerbation and to the consideration of optimal treatment strategies.
Collapse
Affiliation(s)
- Laura K Phillips
- Department of Psychology, Harvard University, 33 Kirkland St. Rm. 1206, Cambridge, MA 02138, USA.
| | | | | |
Collapse
|
31
|
Rubino V, Blasi G, Latorre V, Fazio L, d'Errico I, Mazzola V, Caforio G, Nardini M, Popolizio T, Hariri A, Arciero G, Bertolino A. Activity in medial prefrontal cortex during cognitive evaluation of threatening stimuli as a function of personality style. Brain Res Bull 2007; 74:250-7. [PMID: 17720547 DOI: 10.1016/j.brainresbull.2007.06.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 06/25/2007] [Accepted: 06/25/2007] [Indexed: 11/29/2022]
Abstract
Cognitive evaluation of emotional stimuli involves a network of brain regions including the medial prefrontal cortex (mPFC). However, threatening stimuli may be perceived with differential salience in different individuals. The goal of our study was to evaluate how different personality styles are associated with differential modulation of brain activity during explicit recognition of fearful and angry facial expressions. Twenty-eight healthy subjects underwent fMRI. Based on a cognitivist model, subjects were categorized according to how they attribute salience to emotional stimuli and how they regulate their emotional activation. We compared 14 phobic prone (PP) subjects, whose identity is more centered on the inner experience ("inward") and around control of environmental threat, and 14 eating disorders prone (EDP) subjects, whose identity is more centered on external referential contexts ("outward") and much less around control of threatening stimuli. During fMRI subjects either matched the identity of one of two angry and fearful faces to that of a simultaneously presented target face or identified the expression of a target face by choosing one of two simultaneously presented linguistic labels. The fMRI results indicated that PP subjects had greater mPFC activation when compared with EDP subjects during cognitive labeling of threatening stimuli. Activity in the mPFC also correlated with personality style scores. These results demonstrate that PP subjects recruit greater neuronal resources in mPFC whose activity is associated with cognitive aspects that are closely intertwined with emotional processing. These findings are consistent with the contention that cognitive evaluation and salience of emotional stimuli are associated with different personality styles.
Collapse
Affiliation(s)
- Valeria Rubino
- Psychiatric Neuroscience Group, Section on Mental Disorders, Department of Psychiatric and Neurological Sciences, University of Bari, Bari, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Williams LM, Das P, Liddell BJ, Olivieri G, Peduto AS, David AS, Gordon E, Harris AWF. Fronto-limbic and autonomic disjunctions to negative emotion distinguish schizophrenia subtypes. Psychiatry Res 2007; 155:29-44. [PMID: 17398080 DOI: 10.1016/j.pscychresns.2006.12.018] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Revised: 11/08/2006] [Accepted: 12/25/2006] [Indexed: 11/17/2022]
Abstract
Schizophrenia patients show a disconnection in amygdala-medial prefrontal cortex and autonomic arousal systems for processing fear. Concurrent functional magnetic resonance imaging [fMRI] and skin conductance recording were used to determine whether these disturbances are specific to fear, or present in response to other signals of danger. We also examined whether these disturbances distinguish a specific symptom profile. During scanning, 27 schizophrenia (13 paranoid, 14 nonparanoid) and 22 matched healthy control subjects viewed standardized facial expressions of fear, anger and disgust (versus neutral). Skin conductance responses [SCRs]were acquired simultaneously to assess phasic increases in arousal. 'With-arousal' versus 'without-arousal' responses were analysed using non-parametric methods. For controls, 'with-arousal' responses were associated with emotion-specific activity for fear (amygdala), disgust (insula) and anger (anterior cingulate), together with common medial prefrontal cortex [MPFC] engagement, as predicted. Schizophrenia patients displayed abnormally increased phasic arousal, with concomitant reductions in emotion-specific regions and MPFC. These findings may reflect a general disconnection between central and autonomic systems for processing signals of danger. This disjunction was most apparent in patients with a profile of paranoia, coupled with poor social function and insight. Heightened autonomic sensitivity to signals of fear, threat or contamination, without effective neural mechanisms for appraisal, may underlie paranoid delusions which concern threat and contamination, and associated social and interpersonal difficulties.
Collapse
|
33
|
Gordon E, Liddell BJ, Brown KJ, Bryant R, Clark CR, DAS P, Dobson-Stone C, Falconer E, Felmingham K, Flynn G, Gatt JM, Harris A, Hermens DF, Hopkinson PJ, Kemp AH, Kuan SA, Lazzaro I, Moyle J, Paul RH, Rennie CJ, Schofield P, Whitford T, Williams LM. INTEGRATING OBJECTIVE GENE-BRAIN-BEHAVIOR MARKERS OF PSYCHIATRIC DISORDERS. J Integr Neurosci 2007; 6:1-34. [PMID: 17472223 DOI: 10.1142/s0219635207001465] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Accepted: 02/28/2007] [Indexed: 11/18/2022] Open
Abstract
There is little consensus about which objective markers should be used to assess major psychiatric disorders, and predict/evaluate treatment response for these disorders. Clinical practice relies instead on subjective signs and symptoms, such that there is a "translational gap" between research findings and clinical practice. This gap arises from: a) a lack of integrative theoretical models which provide a basis for understanding links between gene-brain-behavior mechanisms and clinical entities; b) the reliance on studying one measure at a time so that linkages between markers are their specificity are not established; and c) the lack of a definitive understanding of what constitutes normative function. Here, we draw on a standardized methodology for acquiring multiple sources of genomic, brain and behavioral data in the same subjects, to propose candidate markers of selected psychiatric disorders: depression, post-traumatic stress disorder, schizophrenia, attention-deficit/hyperactivity disorder and dementia disorders. This methodology has been used to establish a standardized international database which provides a comprehensive framework and the basis for testing hypotheses derived from an integrative theoretical model of the brain. Using this normative base, we present preliminary findings for a number of disorders in relation to the proposed markers. Establishing these objective markers will be the first step towards determining their sensitivity, specificity and treatment prediction in individual patients.
Collapse
Affiliation(s)
- Evian Gordon
- The Brain Resource International Database and the Brain Resource Company, Sydney, NSW 2007, Australia.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
|
35
|
Falloon IRH. Antipsychotic drugs: when and how to withdraw them? PSYCHOTHERAPY AND PSYCHOSOMATICS 2006; 75:133-8. [PMID: 16636628 DOI: 10.1159/000091770] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
36
|
Behrendt RP. Dysregulation of thalamic sensory "transmission" in schizophrenia: neurochemical vulnerability to hallucinations. J Psychopharmacol 2006; 20:356-72. [PMID: 16174672 DOI: 10.1177/0269881105057696] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cholinergic arousal mechanisms predispose thalamic and cortical neurons to fire action potentials at gamma rhythms, which have a tendency to resonate in thalamocortical networks, thereby forming coherent assemblies under constraints of sensory input to specific thalamic nuclei, on the one hand, and prefrontal and limbic attentional mechanisms, on the other. Perception may be based on sustained assemblies of coherent gamma oscillations in thalamocortical circuits. In schizophrenia, the impact of sensory input on self-organization of thalamocortical activity may be generally reduced. As a result, processes underlying perception can become uncoupled from sensory input, particularly at times of hyperarousal, leading to domination of attentional mechanisms and the emergence of hallucinations. Evidence is reviewed that implicates excessive neuronal noise in specific thalamic nuclei in the generation of hallucinations in schizophrenia. Nicotinic receptor abnormalities, dopaminergic hyperactivity and glutamate-receptor hypofunction are reconciled within a model of psychotic symptom generation that places crucial emphasis on dysfunction of the reticular thalamic nucleus.
Collapse
|
37
|
Nilsson BM, Hultman CM, Wiesel FA. Niacin skin-flush response and electrodermal activity in patients with schizophrenia and healthy controls. Prostaglandins Leukot Essent Fatty Acids 2006; 74:339-46. [PMID: 16600583 DOI: 10.1016/j.plefa.2006.02.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2005] [Accepted: 02/08/2006] [Indexed: 11/27/2022]
Abstract
Patients with schizophrenia have in different studies shown reduced niacin sensitivity and lower electrodermal activity (EDA) after auditory stimulation. Peripheral mediation of prostaglandins may have a physiological role in both responses. This motivates study of both niacin response and electrodermal responding in the same patients with schizophrenia. Thirty patients with schizophrenia and 17 controls were investigated with EDA and thereafter given 200mg niacin orally with continuous assessment of skin temperature. The patients showed a delayed temperature increase after niacin ingestion (P=0.002) and a higher frequency of electrodermal non-responding (P<0.05). Response/non-response for niacin correlated with EDA response/non-response in the patient group (P=0.009). The niacin test revealed a slower vasodilation reaction in the patients. The association between response patterns for the niacin test and EDA suggests that a common aberration in skin physiology may be of importance for both reactions in schizophrenia.
Collapse
Affiliation(s)
- B M Nilsson
- Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala SE-75017, Sweden.
| | | | | |
Collapse
|
38
|
Quednow BB, Wagner M, Westheide J, Beckmann K, Bliesener N, Maier W, Kühn KU. Sensorimotor gating and habituation of the startle response in schizophrenic patients randomly treated with amisulpride or olanzapine. Biol Psychiatry 2006; 59:536-45. [PMID: 16139819 DOI: 10.1016/j.biopsych.2005.07.012] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2004] [Revised: 04/04/2005] [Accepted: 07/11/2005] [Indexed: 11/26/2022]
Abstract
BACKGROUND Schizophrenic patients exhibit impairments in prepulse inhibition (PPI) and habituation of the acoustic startle response (ASR). Recent studies suggested that PPI deficits and habituation deficits are normalized after antipsychotic treatment. Despite clear evidence of gating and habituation mechanisms in animal models, it is still unknown which neurotransmitter systems are involved in schizophrenic patients. Thus, we compared the effects of a combined 5-HT2A/D2 and a pure D2/D3 antagonist on PPI and habituation of ASR in patients with schizophrenia. METHODS The ASR was measured in 37 acute schizophrenic patients who were randomized and double-blinded as to treatment with amisulpride or olanzapine. Patients were assessed during the first week and after four and eight weeks of treatment. Twenty healthy matched control subjects were examined likewise. RESULTS Schizophrenic patients showed a significant PPI deficit and significantly decreased startle amplitude at baseline. The gating deficit disappeared after antipsychotic treatment in both treatment groups. Amisulpride sensitized the startle amplitude, whereas startle amplitude was not changed by olanzapine. After correcting for startle amplitude, patients did not show a habituation deficit; however, amisulpride accelerated habituation, whereas olanzapine had no effect. CONCLUSIONS Our findings suggest that the PPI-restoring effect of antipsychotics is probably attributed to a dopamine D2 receptor blockade.
Collapse
Affiliation(s)
- Boris B Quednow
- Department of Psychiatry, University of Bonn, Bonn, Germany.
| | | | | | | | | | | | | |
Collapse
|
39
|
Schell AM, Dawson ME, Rissling A, Ventura J, Subotnik KL, Gitlin MJ, Nuechterlein KH. Electrodermal predictors of functional outcome and negative symptoms in schizophrenia. Psychophysiology 2005; 42:483-92. [PMID: 16008777 DOI: 10.1111/j.1469-8986.2005.00300.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The ability of electrodermal variables to predict negative symptoms and functional outcome over a 1-year period in schizophrenia was investigated in 78 young, recent-onset outpatients. Patients were stabilized on standardized medication and largely free of psychotic symptoms. Higher levels of both tonic (skin conductance level, nonspecific skin conductance response rate) and phasic (number of skin conductance orienting responses) activity were associated with more negative symptoms and with a combination of poorer social and occupational outcome at 1-year follow-up. This pattern was seen in both male and female patients, and in older and younger patients. Results are interpreted as suggesting that high levels of arousal and overreactivity to the environment may interfere with efficient cognitive processing in schizophrenia, contributing to poor outcome, and that negative symptoms might partially serve as a means of coping with overarousal.
Collapse
Affiliation(s)
- Anne M Schell
- Department of Psychology, Occidental College, Los Angeles, California 90041, USA.
| | | | | | | | | | | | | |
Collapse
|
40
|
Nahshoni E, Manor N, Bar F, Stryjer R, Zalsman G, Weizman A. Alterations in QT dispersion in medicated schizophrenia patients following electroconvulsive therapy. Eur Neuropsychopharmacol 2004; 14:121-5. [PMID: 15013027 DOI: 10.1016/s0924-977x(03)00098-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2003] [Revised: 06/17/2003] [Accepted: 06/17/2003] [Indexed: 11/24/2022]
Abstract
QT dispersion (QTd) is a measure of interlead variations of the surface 12-lead electrocardiogram (ECG). Increased QTd, found in various cardiac diseases, reflects cardiac instability and is associated with increased risk for cardiac death. Research suggests a link between antipsychotics, ECG abnormalities (QT prolongation) and increased sudden cardiac mortality rates. However, QTd analysis has been scarcely investigated in schizophrenia patients. We calculated QTd in 20 medicated psychotic inpatients with schizophrenia, before and 3 days after electroconvulsive therapy (ECT), concomitantly with Brief Psychiatric Rating Scale (BPRS) assessment. QT interval and the rate-corrected QT (QTc) were abnormally prolonged before ECT. However, although QT was significantly shortened, QTc showed only a marginal decrease after ECT. QTd, the rate-corrected QTd, as well as BPRS, showed a significant decrease after ECT. Further large-scale studies are warranted to determine if QTd can serve as a marker for response to ECT, and if it is a risk factor for sudden cardiac death in schizophrenia patients.
Collapse
Affiliation(s)
- Eitan Nahshoni
- Geha Mental Health Center, Campus Beilinson, Petach Tivka, Israel.
| | | | | | | | | | | |
Collapse
|
41
|
Wynn JK, Dawson ME, Schell AM, McGee M, Salveson D, Green MF. Prepulse facilitation and prepulse inhibition in schizophrenia patients and their unaffected siblings. Biol Psychiatry 2004; 55:518-23. [PMID: 15023580 DOI: 10.1016/j.biopsych.2003.10.018] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2003] [Revised: 08/26/2003] [Accepted: 10/24/2003] [Indexed: 11/30/2022]
Abstract
BACKGROUND Deficits in schizophrenia patients and their first-degree relatives have been reported in prepulse inhibition (PPI), a phenomenon that measures an early stage of information processing (sensorimotor gating). It is less clear whether these information processing deficits extend to prepulse facilitation (PPF), which measures a later stage of generalized alerting or orienting. METHODS This study examined three separate issues: first, whether schizophrenia patients have deficits in PPI and PPF; second, whether the siblings of patients show deficits in these processes; and third, whether prepulse duration influences the degree of the deficits. These issues were examined in 76 schizophrenia patients, 36 of their siblings, and 41 normal control subjects. RESULTS Patients and siblings did not differ from control subjects in PPI, perhaps due to the use of different procedural parameters compared with other laboratories that have consistently found PPI deficits in schizophrenia patients. Patients and their siblings produced significantly less PPF than control subjects. For both PPI and PPF, prepulse duration was not a significant factor. CONCLUSIONS These results imply that PPF deficits reveal a generalized alerting or orienting deficit that is present in both schizophrenia patients and their siblings, suggesting that this deficit may be tapping an endophenotypic vulnerability factor.
Collapse
Affiliation(s)
- Jonathan K Wynn
- Department of Psychology (MED), University of Southern California, Los Angeles, California 90073, USA
| | | | | | | | | | | |
Collapse
|
42
|
Akdag SJ, Nestor PG, O’Donnell BF, Niznikiewicz MA, Shenton ME, McCarley RW. The startle reflex in schizophrenia: habituation and personality correlates. Schizophr Res 2003; 64:165-73. [PMID: 14613681 PMCID: PMC2845846 DOI: 10.1016/s0920-9964(03)00059-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Schizophrenia has long been associated with abnormal patterns of arousal that are thought to reflect disturbances in the reticular-activating system of the brain. Psychophysiological investigations of sensory responsivity have repeatedly demonstrated reduced reactivity and habituation to moderately intense stimuli in patients with schizophrenia. While not traditionally used as a measure of physiological arousal, the startle reflex represents an alternative method for studying reactivity and habituation in schizophrenia. This study examined eye blink responsivity to a repeatedly presented intense acoustic startle probe in men with chronic schizophrenia and healthy normal controls. Subjects' personality profiles were also measured, as increased reactivity and arousal have been traditionally implicated as a physiological component to the personality trait of neuroticism. Results indicated that schizophrenic subjects did demonstrate significantly reduced rates of habituation to the acoustic startle probe and higher scores on measures of neuroticism in comparison to normal controls. However, no correlation between habituation rate and neuroticism emerged. These studies replicate previous findings of habituation in schizophrenia and provide further evidence for sensory reactivity disturbances in schizophrenia. The relationship of these findings to cognitive disturbances in schizophrenia is considered and directions for future research are discussed.
Collapse
Affiliation(s)
- Sare J. Akdag
- Laboratory of Applied Neuropsychology, Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA
- Laboratory of Neuroscience, Department of Psychiatry, Harvard Medical School/Boston VA Healthcare System, Brockton Division, 116A, Brockton VAMC, 940 Belmont Street, Brockton, MA 02301, USA
| | - Paul G. Nestor
- Laboratory of Applied Neuropsychology, Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA
- Laboratory of Neuroscience, Department of Psychiatry, Harvard Medical School/Boston VA Healthcare System, Brockton Division, 116A, Brockton VAMC, 940 Belmont Street, Brockton, MA 02301, USA
| | - Brian F. O’Donnell
- Laboratory of Neuroscience, Department of Psychiatry, Harvard Medical School/Boston VA Healthcare System, Brockton Division, 116A, Brockton VAMC, 940 Belmont Street, Brockton, MA 02301, USA
- Department of Psychology, Indiana University, Bloomington, IN 47405, USA
| | - Margaret A. Niznikiewicz
- Laboratory of Neuroscience, Department of Psychiatry, Harvard Medical School/Boston VA Healthcare System, Brockton Division, 116A, Brockton VAMC, 940 Belmont Street, Brockton, MA 02301, USA
| | - Martha E. Shenton
- Laboratory of Neuroscience, Department of Psychiatry, Harvard Medical School/Boston VA Healthcare System, Brockton Division, 116A, Brockton VAMC, 940 Belmont Street, Brockton, MA 02301, USA
| | - Robert W. McCarley
- Laboratory of Neuroscience, Department of Psychiatry, Harvard Medical School/Boston VA Healthcare System, Brockton Division, 116A, Brockton VAMC, 940 Belmont Street, Brockton, MA 02301, USA
| |
Collapse
|
43
|
Okada T, Toichi M, Sakihama M. Influences of an anticholinergic antiparkinsonian drug, parkinsonism, and psychotic symptoms on cardiac autonomic function in schizophrenia. J Clin Psychopharmacol 2003; 23:441-7. [PMID: 14520119 DOI: 10.1097/01.jcp.0000088901.24613.b8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The arguments against the use of anticholinergic antiparkinsonian drugs for neuroleptic-induced parkinsonism have been based, in part, on their autonomic side effects. Except for anecdotal case reports, there is little evidence that antiparkinsonian drugs are the main factor causing autonomic dysfunction in schizophrenic patients with parkinsonism. Therefore, in the current study, the separate influences of the anticholinergic antiparkinsonian drug (biperiden), parkinsonism, and psychotic symptoms on cardiac autonomic function were investigated in 48 patients with schizophrenia. Biperiden was discontinued in 33 patients with or without parkinsonism and commenced in 15 patients with parkinsonism. Their parkinsonism and psychotic symptoms were assessed using rating scales, and their cardiac autonomic functions were assessed using the mean R-R interval and 3 methods of analyzing heart rate variability both before and after the change in medication. Consequently, the cardiac autonomic function was not affected by biperiden or the change in parkinsonism. Cardiac vagal function decreased when psychotic symptoms were more pronounced, but cardiac sympathetic function did not show a significant change. Therefore, it appeared that psychotic symptoms played the predominant role in modifying the cardiac autonomic function, implying the existence of autonomic changes associated with cognitive processing and a possible relation between psychotic symptoms and autonomic symptoms in schizophrenia.
Collapse
Affiliation(s)
- Takashi Okada
- Department of Neuropsychiatry, Faculty of Medicine, Kyoto University, Kyoto, Japan.
| | | | | |
Collapse
|
44
|
Behrendt RP. Hallucinations: synchronisation of thalamocortical gamma oscillations underconstrained by sensory input. Conscious Cogn 2003; 12:413-51. [PMID: 12941286 DOI: 10.1016/s1053-8100(03)00017-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
What we perceive is the product of an intrinsic process and not part of external physical reality. This notion is consistent with the philosophical position of transcendental idealism but also agrees with physiological findings on the thalamocortical system. gamma-Frequency rhythms of discharge activity from thalamic and cortical neurons are facilitated by cholinergic arousal and resonate in thalamocortical networks, thereby transiently forming assemblies of coherent gamma oscillations under constraints of sensory input and prefrontal attentional mechanisms. Perception and conscious experience may be based on such assemblies and sensory input to thalamic nuclei plays merely a constraining role in their formation. In schizophrenia, the ability of sensory input to modulate self-organisation of thalamocortical gamma activity may be generally reduced. If during arousal thalamocortical self-organisation is underconstrained by sensory input, then attentional mechanisms alone may determine the content of perception and hallucinations may arise.
Collapse
Affiliation(s)
- R P Behrendt
- MRCPsych, Longley Centre, Norwood Grange Drive, Sheffield S5 7JT, UK.
| |
Collapse
|
45
|
Valkonen-Korhonen M, Tarvainen MP, Ranta-Aho P, Karjalainen PA, Partanen J, Karhu J, Lehtonen J. Heart rate variability in acute psychosis. Psychophysiology 2003; 40:716-26. [PMID: 14696725 DOI: 10.1111/1469-8986.00072] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Heart rate variability (HRV) provides reliable tools to assess the integrity and reactivity of autonomic nervous function. Our aim was to examine HRV in the resting condition and during different mental loads in acute psychosis compared to healthy controls. HRV was measured in 17 first-episode drug-naive patients with psychosis and 21 healthy controls during oddball tasks and while performing the Wisconsin Card Sorting Test. A discrete event series was constructed by an adaptive QRS detector algorithm and power spectrum estimation was carried out. The RMSSD (representing interval differences of successive heartbeats) and the amount of high frequency (HF) power were significantly reduced in patients. Moreover, the patients' HRV remained unaltered during the tasks, whereas in controls the HRV diminished with increasing mental load of the task. Patients with psychosis displayed less short-term HR reactivity than healthy controls. They also failed to adapt HRV according to the task-connected strain. Acute psychosis is characterized by a limited capacity to respond to external demands at the level of autonomic nervous system.
Collapse
|
46
|
Abstract
The effect of acute treatment with clozapine, risperidone and haloperidol on cardiovascular response to open field novelty stress was investigated in rats using radio-telemetry and video-tracking analysis. Pretreatment with clozapine dose-dependently inhibited the pressor response, tachycardia and increase in dP/dt and caused a marked reduction of exploratory locomotor activity. Similar effects were observed after risperidone treatment. Haloperidol treatment markedly reduced locomotor activity but its cardiovascular effects were limited to a more rapid return of heart rate towards baseline levels. These data suggest that particularly the atypical antipsychotic drugs, clozapine and risperidone, but not the typical antipsychotic, haloperidol, reduce cardiovascular stress responses, an effect that could reflect their anxiolytic action. Such anxiolytic effects could contribute to the beneficial clinical effects of atypical antipsychotic drugs in patients with schizophrenia.
Collapse
Affiliation(s)
- Maarten van den Buuse
- Behavioural Neuroscience Laboratory, Mental Health Research Institute of Victoria, Parkville, Victoria 3052, Australia.
| |
Collapse
|
47
|
Williams LLM, Bahramali H, Hemsley DR, Harris AWF, Brown K, Gordon E. Electrodermal responsivity distinguishes ERP activity and symptom profile in schizophrenia. Schizophr Res 2003; 59:115-25. [PMID: 12414068 DOI: 10.1016/s0920-9964(01)00368-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Traditional averaging of late component Event Related Potentials (ERPs) might obscure important psychophysiological subprocesses underlying schizophrenia disturbances in cognitive functioning. One such subprocess could be the active orientation of attention to significant or novel stimuli. In this study, we used skin conductance responses (SCRs) to index orienting responses (ORs). ERP activity was examined in relation to concomitant ORs in a schizophrenia and nonpsychiatric control group. Schizophrenia responses were considered with respect to the Reality Distortion, Disorganisation and Psychomotor Poverty syndromes. METHOD Forty schizophrenia and 40 age and sex matched control subjects were tested. The three schizophrenia syndromes were derived from a principal component analysis of Positive and Negative Syndrome Scale (PANSS) ratings. Auditory ERPs (N100, N200, P200, P300) were elicited using a conventional auditory oddball paradigm, and electrodermal SCR data were acquired simultaneously. RESULTS ERP data were sub-averaged according to the presence/absence of an OR. For both 'with-' and 'without-OR' ERPs, schizophrenia subjects as a group showed reduced N100 (associated with vigilance level) and N200 (associated with response selection) amplitude, and for with-OR responses, they showed an additional reduction in P300 (context processing). Concerning schizophrenia syndromes, Reality Distortion was related primarily to frontal disturbances (earlier N100/N200 latency and decreased P200/P300 amplitude), and Psychomotor Poverty to a generally delayed P300 latency. Similarly delayed P300 in Disorganisation was explained by medication effects. There were no associations with syndromes for without-OR ERPs. CONCLUSION These results suggest that schizophrenia syndromes are dissociated with regard to both the direction and nature of speed of information processing disturbances, in relation to task-relevant information that produces active orientation.
Collapse
Affiliation(s)
- Leanne Lea M Williams
- Cognitive Neuroscience Unit, Department of Psychology, University of Sydney, Sydney NSW 2006, Australia.
| | | | | | | | | | | |
Collapse
|
48
|
|
49
|
Valkonen-Korhonen M, Könönen M, Yppärilä H, Sipilä P, Lehtonen J, Partanen J, Tarkka IM, Karhu J. Cerebral signs of altered adaptability in females with acute psychosis. Schizophr Res 2002; 55:291-301. [PMID: 12048153 DOI: 10.1016/s0920-9964(01)00282-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In psychosis, behavior is not guided by sensory cues from surroundings. Novel, meaningful behaviors require intact integrative functions such as short-term memory and motor planning, as well as an optimized level of arousal. In this study, we monitored markers of automatic auditory processing in 15 female never-medicated psychotic patients. Fifty-eight channels of EEG were recorded simultaneously with sympathetic skin responses while arousing auditory stimuli were delivered. Neuropsychological tests concentrating on frontal lobe functions were also performed. Prominent neurophysiological and behavioral signs of increased cortical activation were observed in psychotic patients. This widespread disinhibition may attempt to compensate for the impairment of neuronal processing of sensory input from surroundings in the earliest stages of a psychotic illness.
Collapse
|
50
|
Gispen-de Wied CC, Jansen LMC. The stress-vulnerability hypothesis in psychotic disorders: focus on the stress response systems. Curr Psychiatry Rep 2002; 4:166-70. [PMID: 12003677 DOI: 10.1007/s11920-002-0022-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The vulnerabilty stress model is an intriguing concept to look into the etiology of psychotic disorders and, in particular, into the "nature nurture" principle. That stress affects a vulnerable nature may be obvious, but its mechanism is not well understood, and many questions remain to be answered, let alone how to define "vulnerability". The present review tries to focus on the core issues of the vulnerability stress concept--identifying vulnerability, the way stress interferes with it, and the possiblilities of modulating their interaction. Attention is drawn to the biologic stress response systems, the autonomic nervous system (ANS), the hypothalamic pituitary adrenal (HPA) system, and the immune system, and highlights the plasticity of the HPA system as the mediator of adaptation.
Collapse
Affiliation(s)
- Christine C Gispen-de Wied
- Department of Psychiatry (A01.126), University Medical Centre, PO Box 85500, Utrecht, 3508 GA, The Netherlands.
| | | |
Collapse
|