Altered asymmetries of resting-state MRI in the left thalamus of first-episode schizophrenia

Voxel-based alterations in spontaneous brain activity among very-late-onset schizophrenia-like psychosis: A preliminary resting-state functional magnetic resonance imaging study

BACKGROUND

Very late-onset schizophrenia-like psychosis (VLOSLP) is a subtype of schizophrenia spectrum disorders in which individuals experience psychotic symptoms for the first time after the age of 60. The incidence of VLOSLP shows a linear relationship with increasing age. However, no studies have reported alterations in spontaneous brain activity among VLOSLP patients and their correlation with cognitive function and clinical symptoms.

AIM

To explore VLOSLP brain activity and correlations with cognitive function and clinical symptoms using resting-state functional magnetic resonance imaging.

METHODS

This study included 33 VLOSLP patients and 34 healthy controls. The cognitive assessment utilized the Mini Mental State Examination, Montreal Cognitive Assessment, and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clinical characteristic acquisition was performed via the Positive and Negative Syndrome Scale (PANSS). All participants were scanned via resting-state functional magnetic resonance imaging, and the data were processed using amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity, and voxel-mirrored homotopic connectivity (VMHC).

RESULTS

The VLOSLP group presented decreased ALFF values in the left cuneus, right precuneus, right precentral gyrus, and left paracentral lobule; increased fALFF values in the left caudate nucleus; decreased fALFF values in the right calcarine fissure and surrounding cortex (CAL) and right precuneus; increased regional homogeneity values in the right putamen; and decreased VMHC values in the bilateral CAL, bilateral superior temporal gyrus, and bilateral cuneus. In the VLOSLP group, ALFF values in the right precuneus were negatively correlated with Mini Mental State Examination score and PANSS positive subscale score, and VMHC values in the bilateral CAL were negatively correlated with the RBANS total score, RBANS delayed memory score, and PANSS positive subscale score.

CONCLUSION

The changes of brain activity in VLOSLP are concentrated in the right precuneus and bilateral CAL regions, which may be associated with cognitive impairment and clinically positive symptoms.

Meta‐Analysis of Brain Structure in Magnetic Resonance Imaging Studies of Adolescents With Schizophrenia

Background: Adolescence is a critical stage for neurobiological development, including the formulation of advanced cognitive functions. It is also a period of immense susceptibility to psychiatric disorders, meaning that there may be cortical structural abnormalities in adolescents with these conditions, including schizophrenia. Adolescents with schizophrenia also tend to have symptoms that are common to a variety of psychiatric disorders, leading to diagnostic challenges. Thus, we meta‐analyzed MRI data to study the structural brain characteristics of adolescent with schizophrenia.

Methods: We used “early onset schizophrenia, child/children/childhood onset schizophrenia, adolescent/adolescence onset schizophrenia, and magnetic resonance imaging (MRI)” as keywords for searches in the PubMed, Web of Science, EBSCO databases, and ClincalTrial.gov to find English‐language articles publicly available before March 31, 2023. This meta‐analysis was registered on PROSPERO (CRD42023404619) and followed the guidelines of PRISMA.

Results: Twenty‐nine publications were included in the final meta‐analysis, involving 726 patients and 1039 healthy controls. We found data available only in structural brain volume for meta‐analysis. Gray matter (GM) structures in the frontal, occipital, and parietal areas, as well as the thalamus, were significantly reduced, while the lateral ventricles were significantly increased. In patients with childhood‐onset schizophrenia (COS), total GM, frontal, parietal, and lateral ventricle volume were significantly altered. Patients with first‐episode drug‐naïve (FEDN) schizophrenia had a significant atrophy in the frontal and parietal, occipital, and thalamus, along with enlarged lateral ventricles. Additionally, in the sum of GM and white matter, total brain volume, temporal, and left temporal were significantly decreased, but putamen was increased. In COS patients, total brain volume was reduced considerably, but putamen volumes were significantly increased.

Conclusions: Our study indicates that there are extensive structural abnormalities in the brain regions of adolescent schizophrenics, especially within cortical structures. Patients with either COS or non‐first‐episode schizophrenia who may have received antipsychotic medication also exhibited extensive structural brain abnormalities. The thalamus, lateral ventricles, and putamen may be crucial biological markers of structural brain abnormalities in adolescent schizophrenia, providing a basis for exploring the pathological mechanisms underlying the disease, as well as essential targets for early diagnosis and treatments.

Psychiatric manifestations in moyamoya disease: more than a puff of smoke? a systematic review and a case-reports meta-analysis

Introduction

Moyamoya disease (MMD) is a life-threatening condition characterized by stenosis of intracranial arteries. Despite the frequency and the impact of psychiatric symptoms on the long-term prognosis and quality of life of MMD patients, no systematic review on this topic exists.

Methods

This systematic review and meta-analysis included 41 studies (29 being case reports), from PubMed, Scopus, Embase until 27/3/2023, on MMD patients exhibiting psychiatric symptoms.

Results

Despite a fair average quality of the articles, quantitative synthesis through logistic regression was possible only for case reports, due to heterogeneity between the other studies. Psychosis, the most frequent psychiatric symptom reported in case reports, was more frequent in MMD patients with left hemisphere involvement. Neurological symptoms occurrence increased the odds of MMD diagnosis preceding psychiatric symptoms. Psychiatric symptoms are highly prevalent in MMD patients and are relatively often the only presenting symptoms.

Discussion

We discuss the diagnostic, therapeutic, and prognostic implications of recognizing and characterizing specific psychiatric symptoms in MMD, outlining preliminary guidelines for targeted pharmacological and psychotherapeutic interventions. Lastly, we outline future research and clinical perspectives, striving to enhance the oft-overlooked psychiatric care for MMD patients and to ameliorate their long-term outcome.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023406303.

The effects of acupuncture therapy in migraine: An activation likelihood estimation meta-analysis

Background

Previous functional magnetic resonance imaging studies indicated that acupuncture could activate the brain regions in patients with migraine. However, these studies showed inconsistent results. This activation likelihood estimation (ALE) meta-analysis aimed to investigate the consistent activated change of brain regions between pre- and post-acupuncture treatment in migraineurs.

Methods

We conducted a literature search in PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, the Wanfang Database, and the Chinese Biomedical Literature Database from their inception to 18 August, 2022, to obtain articles assessing the functional magnetic resonance imaging changes of acupuncture for migraine. Two investigators independently performed literature selection, data extraction, and quality assessment. The methodological quality was assessed with a modified version of the checklist. The reporting quality of interventions among included studies was evaluated by the Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). Our meta-analysis was conducted according to the GingerALE software. The Jackknife sensitivity analysis was used to assess the robustness of the results.

Results

14 articles were finally included according to the eligible criteria. Regarding the immediate effect of acupuncture on migraine, the ALE meta-analysis demonstrated that the deactivation regions were mainly located in the superior frontal gyrus, and middle frontal gyrus (uncorrected P < 0.001). The ALE meta-analysis of the cumulative effect showed that the activation regions were the thalamus, superior frontal gyrus, posterior lobe of the cerebellum, insula, middle frontal gyrus, precentral gyrus, anterior cingulate, and the deactivation brain regions were located in the transverse temporal gyrus, postcentral gyrus, superior temporal gyrus, anterior cingulate, parahippocampal gyrus, inferior parietal lobule, and inferior occipital gyrus (uncorrected P < 0.001).

Conclusion

Acupuncture could activate multiple brain areas related with the regulation of pain conduction, processing, emotion, cognition, and other brain regions in patients with migraine. In the future, the combination of multiple imaging technologies could be a new approach to deeply investigate the central mechanism of acupuncture for migraine.