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Lin B, Li XB, Ruan S, Wu YX, Zhang CY, Wang CY, Wang LB. Convergent and divergent gray matter volume abnormalities in unaffected first-degree relatives and ultra-high risk individuals of schizophrenia. SCHIZOPHRENIA 2022; 8:55. [PMID: 35853913 PMCID: PMC9261104 DOI: 10.1038/s41537-022-00261-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/24/2022] [Indexed: 01/10/2023]
Abstract
High-risk populations of schizophrenia can be mainly identified as genetic high-risk based on putative endophenotypes or ultra-high-risk (UHR) based on clinically manifested symptoms. Previous studies have consistently shown brain structural abnormalities in both genetic high-risk and UHR individuals. In this study, we aimed to disentangle the convergent and divergent pattern of gray matter alterations between UHR and unaffected first-degree relatives from genetic high-risk individuals. We used structural MRI scans and voxel-based morphometry method to examine gray matter volume (GMV) differences among 23 UHR subjects meeting the Structured Interview for Prodromal Syndromes (SIPS) criteria, 18 unaffected first-degree relatives (UFDR), 26 first-episode schizophrenia patients (FES) and 54 healthy controls (CN). We found that a number of brain regions exhibited a monotonically decreasing trend of GMV from CN to UFDR to UHR to FES. Compared with CN, the UHR subjects showed significant decreases of GMV similar to the patients in the inferior temporal gyrus, fusiform gyrus, middle occipital gyrus, insula, and limbic regions. Moreover, the UHR transformed subgroup had significantly lower GMV than UHR non-transformed subgroup in the right inferior temporal/fusiform gyrus. On the other hand, the UFDR subjects only showed significant GMV decreases in the inferior temporal gyrus and fusiform. Moreover, we found GMV in the occipital lobe was negatively correlated with the UHR subjects’ composite positive symptom of SIPS, and GMV in the cerebellum was positively correlated with FES subjects’ symptom severity. Our results suggest that GMV deficits and regional dysfunction are evident prior to the onset of psychosis and are more prominent in the UHR than the UFDR individuals.
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Vanes LD, Murray RM, Nosarti C. Adult outcome of preterm birth: Implications for neurodevelopmental theories of psychosis. Schizophr Res 2022; 247:41-54. [PMID: 34006427 DOI: 10.1016/j.schres.2021.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/22/2022]
Abstract
Preterm birth is associated with an elevated risk of developmental and adult psychiatric disorders, including psychosis. In this review, we evaluate the implications of neurodevelopmental, cognitive, motor, and social sequelae of preterm birth for developing psychosis, with an emphasis on outcomes observed in adulthood. Abnormal brain development precipitated by early exposure to the extra-uterine environment, and exacerbated by neuroinflammation, neonatal brain injury, and genetic vulnerability, can result in alterations of brain structure and function persisting into adulthood. These alterations, including abnormal regional brain volumes and white matter macro- and micro-structure, can critically impair functional (e.g. frontoparietal and thalamocortical) network connectivity in a manner characteristic of psychotic illness. The resulting executive, social, and motor dysfunctions may constitute the basis for behavioural vulnerability ultimately giving rise to psychotic symptomatology. There are many pathways to psychosis, but elucidating more precisely the mechanisms whereby preterm birth increases risk may shed light on that route consequent upon early neurodevelopmental insult.
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Affiliation(s)
- Lucy D Vanes
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Brunner G, Gajwani R, Gross J, Gumley AI, Krishnadas R, Lawrie SM, Schwannauer M, Schultze-Lutter F, Fracasso A, Uhlhaas PJ. Hippocampal structural alterations in early-stage psychosis: Specificity and relationship to clinical outcomes. NEUROIMAGE: CLINICAL 2022; 35:103087. [PMID: 35780662 PMCID: PMC9421451 DOI: 10.1016/j.nicl.2022.103087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
Individuals with early-stage psychosis show reduced hippocampal volumes. FEP show bilateral and widespread changes, while left hemisphere is affected in CHR-P. However, hippocampal changes do not show a relationship with clinical outcomes.
Hippocampal dysfunctions are a core feature of schizophrenia, but conflicting evidence exists whether volumetric and morphological changes are present in early-stage psychosis and to what extent these deficits are related to clinical trajectories. In this study, we recruited individuals at clinical high risk for psychosis (CHR-P) (n = 108), patients with a first episode of psychosis (FEP) (n = 37), healthy controls (HC) (n = 70) as well as a psychiatric control group with substance abuse and affective disorders (CHR-N: n = 38). MRI-data at baseline were obtained and volumetric as well as vertex analyses of the hippocampus were carried out. Moreover, volumetric changes were examined in the amygdala, caudate, nucleus accumbens, pallidum, putamen and thalamus. In addition, we obtained follow-up functional and symptomatic assessments in CHR-P individuals to examine the question whether anatomical deficits at baseline predicted clinical trajectories. Our results show that the hippocampus is the only structure showing significant volumetric decrease in early-stage psychosis, with FEPs showing significantly smaller hippocampal volumes bilaterally alongside widespread shape changes in the vertex analysis. For the CHR-P group, volumetric decreases were confined to the left hippocampus. However, hippocampal alterations in the CHR-P group were not robustly associated with clinical outcomes, including the persistence of attenuated psychotic symptoms and functional trajectories. Accordingly, our findings highlight that dysfunctions in hippocampal anatomy are an important feature of early-stage psychosis which may, however, not be related to clinical outcomes in CHR-P participants.
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Affiliation(s)
- Gina Brunner
- Institute for Neuroscience and Psychology, Univ. of Glasgow, UK
| | | | - Joachim Gross
- Institute for Neuroscience and Psychology, Univ. of Glasgow, UK; Institute of Biomagnetism and Biosignalanalysis, University of Muenster, Muenster, Germany
| | | | | | | | | | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | | | - Peter J Uhlhaas
- Institute for Neuroscience and Psychology, Univ. of Glasgow, UK; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
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4
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Tognin S, Richter A, Kempton MJ, Modinos G, Antoniades M, Azis M, Allen P, Bossong MG, Perez J, Pantelis C, Nelson B, Amminger P, Riecher-Rössler A, Barrantes-Vidal N, Krebs MO, Glenthøj B, Ruhrmann S, Sachs G, Rutten BPF, de Haan L, van der Gaag M, Valmaggia LR, McGuire P, Antoniades M, Pisani S, Modinos G, de Haan L, van der Gaag M, Velthorst E, Kraan TC, van Dam DS, Burger N, Nelson B, McGorry P, Amminger GP, Pantelis C, Politis A, Goodall J, Riecher-Rössler A, Borgwardt S, Studerus E, Bressan R, Gadelha A, Brietzke E, Asevedo G, Asevedo E, Zugman A, Barrantes-Vidal N, Domínguez-Martínez T, Racciopi A, Kwapil TR, Monsonet M, Hinojosa L, Kazes M, Daban C, Bourgin J, Gay O, Mam-Lam-Fook C, Krebs MO, Nordholm D, Randers L, Krakauer K, Glenthøj L, Glenthøj B, Nordentoft M, Ruhrmann S, Gebhard D, Arnhold J, Klosterkötter J, Sachs G, Lasser I, Winklbaur B, Aschauer H, Delespaul PA, Rutten BP, van Os J, Valmaggia LR, McGuire P. The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac040. [PMID: 35903803 PMCID: PMC9309497 DOI: 10.1093/schizbullopen/sgac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis. Methods 265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes. Results Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline (P < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis. Conclusions In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Mathilde Antoniades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matilda Azis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthijs G Bossong
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Jesus Perez
- CAMEO Early Intervention in Psychosis Services, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia
| | | | | | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Center for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Hospitalo-Universitaire department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Services Capital Region of Denmark, Mental Health Center Glostrup, Glostrup, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Amsterdam Public Mental Health Research Institute, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
| | | | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) , UK
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5
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Ohi K, Nemoto K, Kataoka Y, Sugiyama S, Muto Y, Shioiri T, Kawasaki Y. Alterations in hippocampal subfield volumes among schizophrenia patients, their first-degree relatives and healthy subjects. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110291. [PMID: 33662534 DOI: 10.1016/j.pnpbp.2021.110291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/01/2021] [Accepted: 02/23/2021] [Indexed: 01/04/2023]
Abstract
Reduced hippocampal volumes feature prominently in schizophrenia patients (SCZ). Although several studies have investigated hippocampal volume alterations between unaffected first-degree relatives (FR) of SCZ and healthy controls (HC), the results were inconsistent. Furthermore, it remains unclear whether FR have specific alterations in hippocampal subfield volumes. Three-Tesla T1-weighted MP-RAGE brain scans were collected from 347 subjects (138 SCZ, 47 FR and 162 HC) and processed using the hippocampal subfields algorithm in FreeSurfer v6.0. We investigated volumetric differences in the twelve hippocampal subfields bilaterally among SCZ, FR and HC. SCZ displayed bilateral reductions in whole hippocampal volume compared with FR and HC. The hippocampal volumes of FR did not differ from those of HC but exceeded those observed in SCZ. We found volumetric differences in specific hippocampal subfields, including the CA1, hippocampal fissure, presubiculum, molecular layer, fimbria and hippocampal-amygdala transitional area, among diagnostic groups. These alterations arose from differences in the hippocampal subfield volumes between SCZ and the other two diagnostic groups. However, right hippocampal fissure volumes linearly increased among the groups. In contrast, no significant volumetric differences were found in other hippocampal subfields between HC and FR. There were no significant intergroup differences in laterality in any hippocampal subfield volumes and no significant correlations between hippocampal subfield volumes and illness duration, psychiatric symptoms, antipsychotics or premorbid IQ in SCZ. Our findings suggest that volumetric alterations in hippocampal subfields (except the hippocampal fissure) in SCZ could be stable phenomena that are present at illness onset and minimally affected by antipsychotics.
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Affiliation(s)
- Kazutaka Ohi
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan; Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
| | - Kiyotaka Nemoto
- Department of Neuropsychiatry, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yuzuru Kataoka
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Shunsuke Sugiyama
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yukimasa Muto
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Toshiki Shioiri
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasuhiro Kawasaki
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
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6
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Sasabayashi D, Yoshimura R, Takahashi T, Takayanagi Y, Nishiyama S, Higuchi Y, Mizukami Y, Furuichi A, Kido M, Nakamura M, Noguchi K, Suzuki M. Reduced Hippocampal Subfield Volume in Schizophrenia and Clinical High-Risk State for Psychosis. Front Psychiatry 2021; 12:642048. [PMID: 33828496 PMCID: PMC8019805 DOI: 10.3389/fpsyt.2021.642048] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/19/2021] [Indexed: 11/13/2022] Open
Abstract
Magnetic resonance imaging (MRI) studies in schizophrenia demonstrated volume reduction in hippocampal subfields divided on the basis of specific cytoarchitecture and function. However, it remains unclear whether this abnormality exists prior to the onset of psychosis and differs across illness stages. MRI (3 T) scans were obtained from 77 patients with schizophrenia, including 24 recent-onset and 40 chronic patients, 51 individuals with an at-risk mental state (ARMS) (of whom 5 subsequently developed psychosis within the follow-up period), and 87 healthy controls. Using FreeSurfer software, hippocampal subfield volumes were measured and compared across the groups. Both schizophrenia and ARMS groups exhibited significantly smaller volumes for the bilateral Cornu Ammonis 1 area, left hippocampal tail, and right molecular layer of the hippocampus than the healthy control group. Within the schizophrenia group, chronic patients exhibited a significantly smaller volume for the left hippocampal tail than recent-onset patients. The left hippocampal tail volume was positively correlated with onset age, and negatively correlated with duration of psychosis and duration of medication in the schizophrenia group. Reduced hippocampal subfield volumes observed in both schizophrenia and ARMS groups may represent a common biotype associated with psychosis vulnerability. Volumetric changes of the left hippocampal tail may also suggest ongoing atrophy after the onset of schizophrenia.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ryo Yoshimura
- Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Health Administration Center, University of Toyama, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Mizukami
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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Mora S, Merchán A, Aznar S, Flores P, Moreno M. Increased amygdala and decreased hippocampus volume after schedule-induced polydipsia in high drinker compulsive rats. Behav Brain Res 2020; 390:112592. [PMID: 32417273 DOI: 10.1016/j.bbr.2020.112592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/04/2020] [Accepted: 02/25/2020] [Indexed: 02/08/2023]
Abstract
Fronto-limbic structures and serotonin 2A receptors (5-HT2A) have been implicated in the pathophysiology and treatment of compulsive spectrum disorders. Schedule-Induced Polydipsia (SIP), characterized by the development of excessive drinking under intermittent food reinforcement schedules, is a valid preclinical model for studying the compulsive phenotype. In the present study, we explored the individual differences and effect of SIP in brain volume and 5-HT2A receptor binding in fronto-limbic structures in rats selected according to their compulsive drinking behavior. Rats were divided into high (HD) and low drinkers (LD) by SIP (20 sessions); later, we analyzed the brains of HD and LD selected rats, in two different conditions: non-re-exposure (NRE) or re-exposure to SIP (RE), with four groups: LD-NRE, LD-RE, HD-NRE and HD-RE. Histological analyses were carried out for volumetric (stereology) and receptor binding (autoradiography) in the prelimbic and infralimbic cortex, dorsal hippocampus and basolateral amygdala. After SIP re-exposure, HD-RE showed an increased basolateral amygdala and a reduced hippocampus volume compared to HD-NRE rats, and also compared to LD-RE rats. No differences were found between HD and LD in NRE condition. Moreover, HD rats exhibit a lower 5-HT2A receptor binding in the basolateral amygdala, independently of SIP re-exposure, compared to LD rats. However, LD-RE showed a decreased 5-HT2A receptor binding in basolateral amygdala compared to LD-NRE. No differences were found in the remaining structures. These findings suggest that SIP might be differentially impacting HD and LD brains, pointing towards a possible explanation of how the latent vulnerability to compulsivity is triggered.
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Affiliation(s)
- Santiago Mora
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Ana Merchán
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Susana Aznar
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | - Pilar Flores
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Margarita Moreno
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain.
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8
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Sasabayashi D, Takayanagi Y, Takahashi T, Katagiri N, Sakuma A, Obara C, Katsura M, Okada N, Koike S, Yamasue H, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Subcortical Brain Volume Abnormalities in Individuals With an At-risk Mental State. Schizophr Bull 2020; 46:834-845. [PMID: 32162659 PMCID: PMC7342178 DOI: 10.1093/schbul/sbaa011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan,To whom correspondence should be addressed; Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan; tel: +81-76-434-7323, fax: +81-76-434-5030, e-mail:
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naohiro Okada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan,Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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9
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Nogovitsyn N, Souza R, Muller M, Srajer A, Metzak PD, Hassel S, Ismail Z, Protzner A, Bray SL, Lebel C, MacIntosh BJ, Goldstein BI, Wang J, Kennedy SH, Addington J, MacQueen GM. Aberrant limbic brain structures in young individuals at risk for mental illness. Psychiatry Clin Neurosci 2020; 74:294-302. [PMID: 32003517 DOI: 10.1111/pcn.12985] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/06/2020] [Accepted: 01/20/2020] [Indexed: 12/13/2022]
Abstract
AIM Alterations in limbic structures may be present before the onset of serious mental illness, but whether subfield-specific limbic brain changes parallel stages in clinical risk is unknown. To address this gap, we compared the hippocampus, amygdala, and thalamus subfield-specific volumes in adolescents at various stages of risk for mental illness. METHODS MRI scans were obtained from 182 participants (aged 12-25 years) from the Canadian Psychiatric Risk and Outcome study. The sample comprised of four groups: asymptomatic youth at risk due to family history of mental illness (Stage 0, n = 32); youth with early symptoms of distress (Stage 1a, n = 41); youth with subthreshold psychotic symptoms (Stage 1b, n = 72); and healthy comparison participants with no family history of serious mental illness (n = 37). Analyses included between-group comparisons of brain measurements and correlational analyses that aimed to identify significant associations between neuroimaging and clinical measurements. A machine-learning technique examined the discriminative properties of the clinical staging model. RESULTS Subfield-specific limbic volume deficits were detected at every stage of risk for mental illness. A machine-learning classifier identified volume deficits within the body of the hippocampus, left amygdala nuclei, and medial-lateral nuclei of the thalamus that were most informative in differentiating between risk stages. CONCLUSION Aberrant subfield-specific changes within the limbic system may serve as biological evidence to support transdiagnostic clinical staging in mental illness. Differential patterns of volume deficits characterize those at risk for mental illness and may be indicative of a risk-stage progression.
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Affiliation(s)
- Nikita Nogovitsyn
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Roberto Souza
- Department of Radiology and Clinical Neuroscience, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Meghan Muller
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amelia Srajer
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Paul D Metzak
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Stefanie Hassel
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Andrea Protzner
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Psychology, University of Calgary, Calgary, Canada
| | - Signe L Bray
- Department of Radiology, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, Calgary, Canada.,Child & Adolescent Imaging Research (CAIR) Program, Calgary, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, Calgary, Canada.,Child & Adolescent Imaging Research (CAIR) Program, Calgary, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - JianLi Wang
- Work & Mental Health Research Unit, University of Ottawa Institute of Mental Health Research, Ottawa, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Psychiatry, Krembil Research Centre, University Health Network, University of Toronto, Toronto, Canada.,Department of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, Canada.,Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Jean Addington
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
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10
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Structural and functional imaging markers for susceptibility to psychosis. Mol Psychiatry 2020; 25:2773-2785. [PMID: 32066828 PMCID: PMC7577836 DOI: 10.1038/s41380-020-0679-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/15/2020] [Accepted: 01/31/2020] [Indexed: 12/21/2022]
Abstract
The introduction of clinical criteria for the operationalization of psychosis high risk provided a basis for early detection and treatment of vulnerable individuals. However, about two-thirds of people meeting clinical high-risk (CHR) criteria will never develop a psychotic disorder. In the effort to increase prognostic precision, structural and functional neuroimaging have received growing attention as a potentially useful resource in the prediction of psychotic transition in CHR patients. The present review summarizes current research on neuroimaging biomarkers in the CHR state, with a particular focus on their prognostic utility and limitations. Large, multimodal/multicenter studies are warranted to address issues important for clinical applicability such as generalizability and replicability, standardization of clinical definitions and neuroimaging methods, and consideration of contextual factors (e.g., age, comorbidity).
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11
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Hinney B, Walter A, Aghlmandi S, Andreou C, Borgwardt S. Does Hippocampal Volume Predict Transition to Psychosis in a High-Risk Group? A Meta-Analysis. Front Psychiatry 2020; 11:614659. [PMID: 33519555 PMCID: PMC7840882 DOI: 10.3389/fpsyt.2020.614659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/14/2020] [Indexed: 01/11/2023] Open
Abstract
Schizophrenia has a prodromal phase of several years in most patients, making it possible to identify patients at clinical high risk (CHR) for developing the disorder. So far, these individuals are identified based on clinical criteria alone, and there is no reliable biomarker for predicting the transition to psychosis. It is well-established that reductions in brain volume, especially in the hippocampus, are associated with schizophrenia. Therefore, hippocampal volume may serve as a biomarker for psychosis. Several studies have already investigated hippocampal volume in CHR groups. Based on these studies, the present meta-analysis compares the baseline left and right hippocampal volume of CHR patients who developed a psychosis with that of CHR patients without such a transition. Our results show no statistically significant effect of the hippocampal volume on the transition risk for psychosis.
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Affiliation(s)
- Bernd Hinney
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Anna Walter
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Soheila Aghlmandi
- Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
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12
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Do cognitive and neuropsychological functioning deficits coincide with hippocampal alteration during first-psychotic episode? CNS Spectr 2019; 24:472-478. [PMID: 30507369 DOI: 10.1017/s1092852918001293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Numerous studies shown that structural hippocampal alterations are present in subjects at high risk of developing psychosis or schizophrenia. These findings indicate that in a subset of patients undergoing first-psychosis episode (FPE), hippocampal volume alterations are accompanied by associated cognitive and neuropsychological deficits. The combination of psychological deficits and neuroanatomical alterations, in turn, appears to increase treatment complexity and worsen clinical outcomes. OBJECTIVE We aim to determine whether cognitive and neuropsychological functioning deficits precede or follow hippocampal alterations during early onset psychosis. METHODS This cross-sectional study describes 3 case-studies of adolescent subjects, ages 16-17, admitted at the child and adolescent inpatient psychiatric unit in lieu of first psychotic episode. We conducted detailed structured clinical psychiatric interviews, anatomical-structural magnetic resonance imaging (MRI), sleep-deprived electroencephalogram (EEG) recordings, laboratory testing, and a comprehensive battery of psychological testing to better understand their clinical pictures. RESULTS Psychological testing in each patient demonstrated the presence of low to borderline intellectual functioning coupled with neuropsychological deficits in different psychiatric domains. Interestingly, these changes coincided with structural MRI alterations in the hippocampal area. CONCLUSIONS Our case report adds to the armamentarium of literature signifying that radiologically detectable alterations of the hippocampus may occur either concomitantly or closely following the development of early cognitive deficits in patients with FPE.
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13
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Shan XX, Ou YP, Pan P, Ding YD, Zhao J, Liu F, Chen JD, Guo WB, Zhao JP. Increased frontal gray matter volume in individuals with prodromal psychosis. CNS Neurosci Ther 2019; 25:987-994. [PMID: 31129924 PMCID: PMC6698969 DOI: 10.1111/cns.13143] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/27/2019] [Accepted: 04/07/2019] [Indexed: 01/10/2023] Open
Abstract
Background Brain anatomical deficits associated with cognitive dysfunction have been reported in patients with schizophrenia. However, it remains unknown whether such anatomical deficits exist in individuals with prodromal psychosis. The present study is designed to investigate anatomical deficits in prodromal individuals and their associations with clinical/cognitive features. Methods Seventy‐four prodromal individuals and seventy‐six healthy controls were scanned using structural magnetic resonance imaging. Support vector machines were applied to test whether anatomical deficits might be used to discriminate prodromal individuals from healthy controls. Results Prodromal individuals showed significantly increased gray matter volume (GMV) in the right inferior frontal gyrus (IFG) and right rectus gyrus relative to healthy controls. No correlations were observed between increased GMV and clinical/cognitive characteristics. The combination of increased GMV in the right rectus gyrus and right IFG showed a sensitivity of 74.32%, a specificity of 67.11%, and an accuracy of 70.67% in differentiating prodromal individuals from healthy controls. Conclusion Our results provide evidence of increased frontal GMV in prodromal individuals. A combination of GMV values in the two frontal brain areas may serve as potential markers to discriminate prodromal individuals from healthy controls. The results thus highlight the importance of the frontal regions in the pathophysiology of psychosis.
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Affiliation(s)
- Xiao-Xiao Shan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Yang-Pan Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Pan Pan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Yu-Dan Ding
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Jin Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jin-Dong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Wen-Bin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Jing-Ping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
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14
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Development of Neuroimaging-Based Biomarkers in Psychiatry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:159-195. [PMID: 31705495 DOI: 10.1007/978-981-32-9721-0_9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This chapter presents an overview of accumulating neuroimaging data with emphasis on translational potential. The subject will be described in the context of three disease states, i.e., schizophrenia, bipolar disorder, and major depressive disorder, and for three clinical goals, i.e., disease risk assessment, subtyping, and treatment decision.
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15
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Vargas T, Dean DJ, Osborne KJ, Gupta T, Ristanovic I, Ozturk S, Turner J, van Erp TGM, Mittal VA. Hippocampal Subregions Across the Psychosis Spectrum. Schizophr Bull 2018; 44:1091-1099. [PMID: 29272467 PMCID: PMC6101630 DOI: 10.1093/schbul/sbx160] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Converging evidence suggests that hippocampal subregions subserve different functions, and are differentially affected by psychosis illness progression. Despite this fact, studies have not often studied subregions cross-sectionally across the psychosis spectrum. Furthermore, little is known about associations between subregion volumes and hippocampus-mediated cognition. METHODS A total of 222 participants (61 ultra high risk [UHR], 91 schizophrenia [SCZ], and 70 healthy volunteers) underwent a 3T MRI scan, as well as structured clinical interviews and a cognitive battery. Hippocampal subfield analysis was conducted with Freesurfer. We compared subregion volumes across groups, controlling for age, gender, and intracranial volume. We also examined associations in the UHR and SCZ groups between hippocampal subregion volumes and verbal learning, visual learning, and working memory. RESULTS We found a dose-dependent relationship such that the SCZ group showed significantly greater subfield volume reductions than the UHR group, which in turn showed significantly greater subfield volume reductions than the healthy volunteer group. We also found associations between subregion volume and cognitive performance in the visual memory, verbal memory, and working memory domains. DISCUSSION Our study examined hippocampal subregion volumes cross-sectionally in a large sample across the psychosis spectrum, as well as links with hippocampus-mediated cognitive function. Our findings suggest that hippocampal abnormalities emerge before first psychosis episode onset, and may be etiologically informative.
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Affiliation(s)
- Teresa Vargas
- Department of Psychology, Northwestern University, IL,To whom correspondence should be addressed; tel: 847-467-3880, fax: 847-491-7859, e-mail:
| | - Derek J Dean
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | | | - Tina Gupta
- Department of Psychology, Northwestern University, IL
| | | | - Sekine Ozturk
- Department of Psychology, Northwestern University, IL
| | | | - Theo G M van Erp
- Psychiatry & Human Behavior Department, University of California Irvine
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16
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Sasabayashi D, Takayanagi Y, Takahashi T, Koike S, Yamasue H, Katagiri N, Sakuma A, Obara C, Nakamura M, Furuichi A, Kido M, Nishikawa Y, Noguchi K, Matsumoto K, Mizuno M, Kasai K, Suzuki M. Increased Occipital Gyrification and Development of Psychotic Disorders in Individuals With an At-Risk Mental State: A Multicenter Study. Biol Psychiatry 2017; 82:737-745. [PMID: 28709499 DOI: 10.1016/j.biopsych.2017.05.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anomalies of brain gyrification have been reported in schizophrenia, possibly reflecting its neurodevelopmental pathology. However, it remains elusive whether individuals at risk for psychotic disorders exhibit deviated gyrification patterns, and whether such findings, if present, are predictive of transition to psychotic disorders. METHODS This multicenter magnetic resonance imaging study investigated brain gyrification and its relationship to later transition to psychotic disorders in a large sample of at-risk mental state (ARMS) individuals. T1-weighted magnetic resonance imaging scans were obtained from 104 ARMS individuals, of whom 21 (20.2%) exhibited the transition to psychotic disorders during clinical follow-up (mean = 4.9 years, SD = 2.6 years), and 104 healthy control subjects at 4 different sites. The local gyrification index (LGI) of the entire cortex was compared across the groups using FreeSurfer software. RESULTS Compared with the control subjects, ARMS individuals showed a significantly higher LGI in widespread cortical areas, including the bilateral frontal, temporal, parietal, and occipital regions, which was partly associated with prodromal symptomatology. ARMS individuals who exhibited the transition to psychotic disorders showed a significantly higher LGI in the left occipital region compared with individuals without transition. CONCLUSIONS These findings suggested that increased LGI in diverse cortical regions might represent vulnerability to psychopathology, while increased LGI in the left occipital cortex might be related to subsequent manifestation of florid psychotic disorders as a possible surrogate marker.
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Affiliation(s)
- Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Yamasue
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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17
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Sun L, Liu P, Liu F, Zhou Y, Chu Z, Li Y, Chu G, Zhang Y, Wang J, Dang YH. Effects of Hint1 deficiency on emotional-like behaviors in mice under chronic immobilization stress. Brain Behav 2017; 7:e00831. [PMID: 29075577 PMCID: PMC5651401 DOI: 10.1002/brb3.831] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 07/08/2017] [Accepted: 08/15/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Histidine triad nucleotide-binding protein 1 (HINT1) is regarded as a haplo-insufficient tumor suppressor and is closely associated with diverse neuropsychiatric diseases. Moreover, HINT1 is related to gender-specific acute behavior changes in schizophrenia and in response to nicotine. Stress has a range of molecular effects in emotional disorders, which can cause a reduction in brain-derived neurotrophic factor (BDNF) expression in the hippocampus, resulting in hippocampal atrophy and neuronal cell loss. METHODS This study examined the role of HINT1 deficiency in anxiety-related and depression-like behaviors and BDNF expression in the hippocampus under chronic immobilization stress, and investigated whether the sex-specific and haplo-insufficient effects exist in emotional-like behaviors under the same condition. RESULTS In a battery of behavior tests, the results of the control group, not exposed to stress, showed that knockout (KO) and heterozygosity (HT) of Hint1 had anxiolytic-like and antidepression-like effects on the male and female mice. However, both male and female Hint1-KO mice showed elevated anxiety-related and antidepression-like behavior under chronic immobilization stress; moreover, both male and female Hint1-HT mice displayed elevated anxiety-related behavior and increased depression-like behavior under chronic immobilization stress. There were no significant differences in general locomotor activity between Hint1-KO and -HT mice and their wild-type (WT) littermates. Hint1-KO mice under basal and chronic immobilization stress conditions expressed more BDNF in the hippocampus than did Hint1-HT and WT mice; overall, there were no significant sex differences in emotional-like behaviors of Hint1-KO and -HT mice. Additionally, Hint1-HT mice showed haplo-insufficient effects on emotional-like behaviors under basic conditions, rather than under chronic immobilization stress. CONCLUSIONS Both male and female HINT 1 KO and HT mice had a trend of anxiolytic-like behavior and antidepression-like behavior at control group. However, both male and female HINT1 KO mice showed elevated anxiety-related and antidepression-like behavior under chronic immobilization stress; moreover, both male and female HINT1 HT mice displayed elevated anxiety-related behavior and increased depression-like behavior under chronic immobilization stress.
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Affiliation(s)
- Liankang Sun
- First Affiliated Hospital Xi'an Jiaotong University Xi'an China
| | - Peng Liu
- College of Medicine & Forensics Key Laboratory of the Health Ministry for Forensic Medicine Key Laboratory of Environment and Genes Related to Diseases of the Education Ministry Xi'an Jiaotong University Health Science Center Xi'an China
| | - Fei Liu
- College of Medicine & Forensics Key Laboratory of the Health Ministry for Forensic Medicine Key Laboratory of Environment and Genes Related to Diseases of the Education Ministry Xi'an Jiaotong University Health Science Center Xi'an China.,Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases College of Stomatology Xi'an Jiaotong University Xi'an China
| | - Yuan Zhou
- Qi De College Xi'an Jiaotong University Xi'an China
| | - Zheng Chu
- College of Medicine & Forensics Key Laboratory of the Health Ministry for Forensic Medicine Key Laboratory of Environment and Genes Related to Diseases of the Education Ministry Xi'an Jiaotong University Health Science Center Xi'an China
| | - Yuqi Li
- Qi De College Xi'an Jiaotong University Xi'an China
| | - Guang Chu
- Zong Lian College Xi'an Jiaotong University Xi'an China
| | - Ying Zhang
- Qi De College Xi'an Jiaotong University Xi'an China
| | - Jiabei Wang
- Department of Pharmaceutical Sciences School of Pharmacy University of Maryland Baltimore MD USA
| | - Yong-Hui Dang
- College of Medicine & Forensics Key Laboratory of the Health Ministry for Forensic Medicine Key Laboratory of Environment and Genes Related to Diseases of the Education Ministry Xi'an Jiaotong University Health Science Center Xi'an China
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18
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Rapp C, Canela C, Studerus E, Walter A, Aston J, Borgwardt S, Riecher-Rössler A. Duration of untreated psychosis/illness and brain volume changes in early psychosis. Psychiatry Res 2017; 255:332-337. [PMID: 28601717 DOI: 10.1016/j.psychres.2017.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 03/17/2017] [Accepted: 06/02/2017] [Indexed: 01/10/2023]
Abstract
The time period during which patients manifest psychotic or unspecific symptoms prior to treatment (duration of untreated psychosis, DUP, and the duration of untreated illness, DUI) has been found to be moderately associated with poor clinical and social outcome. Equivocal evidence exists of an association between DUP/DUI and structural brain abnormalities, such as reduced hippocampus volume (HV), pituitary volume (PV) and grey matter volume (GMV). Thus, the goal of the present work was to examine if DUP and DUI are associated with abnormalities in HV, PV and GMV. Using a region of interest (ROI) based approach, we present data of 39 patients from the Basel FePsy (Früherkennung von Psychosen, early detection of psychosis) study for which information about DUP, DUI and HV, PV and GMV data could be obtained. Twenty-three of them were first episode psychosis (FEP) and 16 at-risk mental state (ARMS) patients who later made the transition to frank psychosis. In unadjusted analyses, we found a significant positive correlation between DUP and PV in FEP patients. However, when adjusted for covariates, we found no significant correlation between DUP or DUI and HV, PV or GMV anymore. There only was a trend for decreasing GMV with increasing DUI in FEP. Our results do not comprehensively support the hypothesis of a "toxic" effect of the pathogenic mechanism underlying untreated psychosis on brain structure. If there is any effect, it might rather occur very early in the disease process, during which patients experience only unspecific symptoms.
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Affiliation(s)
- Charlotte Rapp
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Kornhausgasse 7, CH-4051 Basel, Switzerland
| | - Carlos Canela
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Erich Studerus
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Kornhausgasse 7, CH-4051 Basel, Switzerland
| | - Anna Walter
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Kornhausgasse 7, CH-4051 Basel, Switzerland
| | - Jacqueline Aston
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Kornhausgasse 7, CH-4051 Basel, Switzerland
| | - Stefan Borgwardt
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Kornhausgasse 7, CH-4051 Basel, Switzerland
| | - Anita Riecher-Rössler
- University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Kornhausgasse 7, CH-4051 Basel, Switzerland.
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19
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A conditioning model of delusion. Neurosci Biobehav Rev 2017; 80:223-239. [PMID: 28601666 DOI: 10.1016/j.neubiorev.2017.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 05/14/2017] [Accepted: 05/29/2017] [Indexed: 11/22/2022]
Abstract
"Delusions" are beliefs that are false and persistent. It is suggested here that these characteristics can emerge from interplays between two fundamental learning processes: (1) the allocation of attentional resources among stimuli; and (2) the effects of feedback on learning. The former of these has been operationalized in the learned irrelevance and latent inhibition paradigms; the latter in studies of the effects of persistence-training. Normally, the attentional process functions to constrain persistence-training effects so that only valid associations acquire persistence. But when persistence-training is less influenced in this way, its mechanisms can interact with a noisy environment to gradually insulate maladaptive associations from disconfirming feedback. When unchecked, these dynamics likely lead to a systematic distortion of beliefs that can become increasingly persistent regardless of their validity. Delusions are therefore predicted to tend to arise whenever the balance of (1) is weakened in favour of (2), whether by experimental manipulation, trait-related factors, cultural causes or evolutionary history. Existing evidence is consistent with the model and further implications are discussed.
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20
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Progressive Decline in Hippocampal CA1 Volume in Individuals at Ultra-High-Risk for Psychosis Who Do Not Remit: Findings from the Longitudinal Youth at Risk Study. Neuropsychopharmacology 2017; 42:1361-1370. [PMID: 28079061 PMCID: PMC5437892 DOI: 10.1038/npp.2017.5] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/05/2016] [Accepted: 01/04/2017] [Indexed: 01/08/2023]
Abstract
Most individuals identified as ultra-high-risk (UHR) for psychosis do not develop frank psychosis. They continue to exhibit subthreshold symptoms, or go on to fully remit. Prior work has shown that the volume of CA1, a subfield of the hippocampus, is selectively reduced in the early stages of schizophrenia. Here we aimed to determine whether patterns of volume change of CA1 are different in UHR individuals who do or do not achieve symptomatic remission. Structural MRI scans were acquired at baseline and at 1-2 follow-up time points (at 12-month intervals) from 147 UHR and healthy control subjects. An automated method (based on an ex vivo atlas of ultra-high-resolution hippocampal tissue) was used to delineate the hippocampal subfields. Over time, a greater decline in bilateral CA1 subfield volumes was found in the subgroup of UHR subjects whose subthreshold symptoms persisted (n=40) and also those who developed clinical psychosis (n=12), compared with UHR subjects who remitted (n=41) and healthy controls (n=54). No baseline differences in volumes of the overall hippocampus or its subfields were found among the groups. Moreover, the rate of volume decline of CA1, but not of other hippocampal subfields, in the non-remitters was associated with increasing symptom severity over time. Thus, these findings indicate that there is deterioration of CA1 volume in persistently symptomatic UHR individuals in proportion to symptomatic progression.
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Pruessner M, Bechard-Evans L, Pira S, Joober R, Collins DL, Pruessner JC, Malla AK. Interplay of hippocampal volume and hypothalamus-pituitary-adrenal axis function as markers of stress vulnerability in men at ultra-high risk for psychosis. Psychol Med 2017; 47:471-483. [PMID: 27774914 DOI: 10.1017/s0033291716002658] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Altered hypothalamus-pituitary-adrenal (HPA) axis function and reduced hippocampal volume (HV) are established correlates of stress vulnerability. We have previously shown an attenuated cortisol awakening response (CAR) and associations with HV specifically in male first-episode psychosis patients. Findings in individuals at ultra-high risk (UHR) for psychosis regarding these neurobiological markers are inconsistent, and assessment of their interplay, accounting for sex differences, could explain incongruent results. METHOD Study participants were 42 antipsychotic-naive UHR subjects (24 men) and 46 healthy community controls (23 men). Saliva samples for the assessment of CAR were collected at 0, 30 and 60 min after awakening. HV was determined from high-resolution structural magnetic resonance imaging scans using a semi-automatic segmentation protocol. RESULTS Cortisol measures and HV were not significantly different between UHR subjects and controls in total, but repeated-measures multivariate regression analyses revealed reduced cortisol levels 60 min after awakening and smaller left HV in male UHR individuals. In UHR participants only, smaller left and right HV was significantly correlated with a smaller total CAR (ρ = 0.42, p = 0.036 and ρ = 0.44, p = 0.029, respectively), corresponding to 18% and 19% of shared variance (medium effect size). CONCLUSIONS Our findings suggest that HV reduction in individuals at UHR for psychosis is specific to men and linked to reduced post-awakening cortisol concentrations. Abnormalities in the neuroendocrine circuitry modulating stress vulnerability specifically in male UHR subjects might explain increased psychosis risk and disadvantageous illness outcomes in men compared to women.
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Affiliation(s)
- M Pruessner
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - L Bechard-Evans
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - S Pira
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - R Joober
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
| | - D L Collins
- Departments of Neurology & Neurosurgery, and Biomedical Engineering,Brain Imaging Centre,Montreal Neurological Institute,McGill University,Montréal,Québec,Canada
| | - J C Pruessner
- Departments of Psychiatry, and Psychology,McGill Centre for Studies in Aging,Douglas Mental Health University Institute,McGill University,Montréal,Québec,Canada
| | - A K Malla
- Department of Psychiatry,Prevention and Early Intervention Program for Psychosis, DouglasMental Health University Institute,McGill University,Montréal,Québec,Canada
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Pruessner M, Cullen AE, Aas M, Walker EF. The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neurosci Biobehav Rev 2017; 73:191-218. [DOI: 10.1016/j.neubiorev.2016.12.013] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
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Gifford G, Crossley N, Fusar-Poli P, Schnack HG, Kahn RS, Koutsouleris N, Cannon TD, McGuire P. Using neuroimaging to help predict the onset of psychosis. Neuroimage 2017; 145:209-217. [PMID: 27039698 DOI: 10.1016/j.neuroimage.2016.03.075] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 03/18/2016] [Accepted: 03/28/2016] [Indexed: 02/08/2023] Open
Abstract
The aim of this review is to assess the potential for neuroimaging measures to facilitate prediction of the onset of psychosis. Research in this field has mainly involved people at 'ultra-high risk' (UHR) of psychosis, who have a very high risk of developing a psychotic disorder within a few years of presentation to mental health services. The review details the key findings and developments in this area to date and examines the methodological and logistical challenges associated with making predictions in an individual subject in a clinical setting.
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Affiliation(s)
- George Gifford
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Nicolas Crossley
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Hugo G Schnack
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Philip McGuire
- Department of Psychosis Studies, The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Walter A, Suenderhauf C, Harrisberger F, Lenz C, Smieskova R, Chung Y, Cannon TD, Bearden CE, Rapp C, Bendfeldt K, Borgwardt S, Vogel T. Hippocampal volume in subjects at clinical high-risk for psychosis: A systematic review and meta-analysis. Neurosci Biobehav Rev 2016; 71:680-690. [DOI: 10.1016/j.neubiorev.2016.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/09/2016] [Accepted: 10/11/2016] [Indexed: 01/16/2023]
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25
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Abstract
OBJECTIVE The molecular and cellular basis of structural and functional abnormalities of the hippocampus found in schizophrenia is currently unclear. Postnatal neurogenesis contributes to hippocampal function in animal models and is correlated with hippocampal volume in primates. Reduced hippocampal cell proliferation has been previously reported in schizophrenia, which may contribute to hippocampal dysfunction. METHOD We measured the cell proliferation marker, Ki67, in post-mortem hippocampal tissue from patients with schizophrenia (n = 10) and matched controls (n = 16). Ki67-labelled cells were counted within the dentate gyrus and hilus on sections taken from the anterior hippocampus. RESULTS We replicated the finding of a significant reduction in Ki67+ cells/mm² in schizophrenia cases compared to controls (t24 = 2.1, p = 0.023). In our relatively small sample, we did not find a relationship between Ki67+ cells and age overall, or between Ki67 + cells and duration of illness or antipsychotic treatment in people with schizophrenia. CONCLUSION Our results confirm that reduced hippocampal cell proliferation may be present in schizophrenia. Restoring hippocampal neurogenesis may be a potential therapeutic target for the treatment of hippocampal dysfunction in schizophrenia.
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Affiliation(s)
- Katherine M Allen
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Samantha J Fung
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Cynthia Shannon Weickert
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia,Cynthia Shannon Weickert, Neuroscience Research Australia, Corner of Barker and Easy Streets, Randwick, Sydney, NSW 2031, Australia.
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Hyperactivity of caudate, parahippocampal, and prefrontal regions during working memory in never-medicated persons at clinical high-risk for psychosis. Schizophr Res 2016; 173:1-12. [PMID: 26965745 PMCID: PMC4836956 DOI: 10.1016/j.schres.2016.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Deficits in working memory (WM) are a core feature of schizophrenia (SZ) and other psychotic disorders. We examined brain activity during WM in persons at clinical high risk (CHR) for psychosis. METHODS Thirty-seven CHR and 34 healthy control participants underwent functional MRI (fMRI) on a 3.0T scanner while performing an N-back WM task. The sample included a sub-sample of CHR participants who had no lifetime history of treatment with psychotropic medications (n=11). Data were analyzed using SPM8 (2-back>0-back contrast). Pearson correlations between brain activity, symptoms, and WM performance were examined. RESULTS The total CHR group and medication-naive CHR sub-sample were comparable to controls in most demographic features and in N-back WM performance, but had significantly lower IQ. Relative to controls, medication-naïve CHR showed hyperactivity in the left parahippocampus (PHP) and the left caudate during performance of the N-back WM task. Relative to medication-exposed CHR, medication naïve CHR exhibited hyperactivity in the left caudate and the right dorsolateral prefrontal cortex (DLPFC). DLPFC activity was significantly negatively correlated with WM performance. PHP, caudate and DLPFC activity correlated strongly with symptoms, but results did not withstand FDR-correction for multiple comparisons. When all CHR participants were combined (regardless of medication status), only trend-level PHP hyperactivity was observed in CHR relative to controls. CONCLUSIONS Medication-naïve CHR exhibit hyperactivity in regions that subserve WM. These regions are implicated in studies of schizophrenia and risk for psychosis. Results emphasize the importance of medication status in the interpretation of task - induced brain activity.
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27
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Association between impaired brain activity and volume at the sub-region of Broca's area in ultra-high risk and first-episode schizophrenia: A multi-modal neuroimaging study. Schizophr Res 2016; 172:9-15. [PMID: 26873807 DOI: 10.1016/j.schres.2016.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/31/2016] [Accepted: 02/03/2016] [Indexed: 11/24/2022]
Abstract
Recent studies have suggested that functional abnormalities in Broca's area, which is important in language production (speech and thoughts before speech), play an important role in the pathophysiology of schizophrenia. While multi-modal approaches have proved useful in revealing the specific pathophysiology of psychosis, the association of functional abnormalities with gray matter volume (GMV) here in subjects with an ultra-high risk (UHR) of schizophrenia, those with first-episode schizophrenia (FES), and healthy controls has yet to be clarified. Therefore, the relationship between cortical activity measured using functional near-infrared spectroscopy (fNIRS) during a verbal fluency task, and GMV in the Broca's area assessed using a manual tracing in magnetic resonance imaging (MRI), which considers individual structural variation, was examined for 57 subjects (23 UHR/18 FES/16 controls). The UHR and FES group showed significantly reduced brain activity compared to control group in the left pars triangularis (PT) (P=.036, .003, respectively). Furthermore in the FES group, the reduced brain activity significantly positively correlated with the volume in the left PT (B=0.29, P=.027), while significant negative association was evident for all subjects (B=-0.18, P=.010). This correlation remained significant after adjusting for antipsychotics dosage, and voxel-wise analysis could not detect any significant correlation between impaired cortical activity and volume. The significant relationship between neural activity and GMV in the left PT may reflect a specific pathophysiology related to the onset of schizophrenia.
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Dean DJ, Orr JM, Bernard JA, Gupta T, Pelletier-Baldelli A, Carol EE, Mittal VA. Hippocampal Shape Abnormalities Predict Symptom Progression in Neuroleptic-Free Youth at Ultrahigh Risk for Psychosis. Schizophr Bull 2016; 42:161-9. [PMID: 26113620 PMCID: PMC4681548 DOI: 10.1093/schbul/sbv086] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Hippocampal abnormalities have been widely studied in schizophrenia spectrum populations including those at ultrahigh risk (UHR) for psychosis. There have been inconsistent findings concerning hippocampal morphology prior to and during the transition to psychosis, and little is known about how specific subregions are related to the symptom progression. METHODS A total of 80 participants (38 UHR and 42 healthy controls) underwent a 3T MRI scan, as well as structured clinical interviews. Shape analysis of hippocampi was conducted with FSL/FIRST vertex analysis to yield a localized measure of shape differences between groups. A subgroup of the sample (24 UHR and 24 controls) also returned for a 12-month clinical follow-up assessment. RESULTS The UHR group exhibited smaller hippocampal volumes bilaterally, and shape analysis revealed significant inversion in the left ventral posterior hippocampus in the UHR group. Greater inversion in this subregion was related to elevated symptomatology at baseline and increased positive symptoms, negative symptoms, and impaired tolerance to normal stress 12 months later. These results did not hold when left hippocampal volume was used as a predictor instead. DISCUSSION This represents the first study to use vertex analysis in a UHR sample and results suggest that abnormalities in hippocampal shape appear to reflect underlying pathogenic processes driving the progression of illness. These findings suggest that examining shape and volume may provide an important new perspective for our conception of brain alterations in the UHR period.
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Affiliation(s)
- Derek J Dean
- Department of Psychology and Neuroscience, Center for Neuroscience, and
| | - Joseph M Orr
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO
| | | | - Tina Gupta
- Department of Psychology and Neuroscience
| | | | | | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL
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Klauser P, Zhou J, Lim JK, Poh JS, Zheng H, Tng HY, Krishnan R, Lee J, Keefe RS, Adcock RA, Wood SJ, Fornito A, Chee MW. Lack of Evidence for Regional Brain Volume or Cortical Thickness Abnormalities in Youths at Clinical High Risk for Psychosis: Findings From the Longitudinal Youth at Risk Study. Schizophr Bull 2015; 41:1285-93. [PMID: 25745033 PMCID: PMC4601700 DOI: 10.1093/schbul/sbv012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There is cumulative evidence that young people in an "at-risk mental state" (ARMS) for psychosis show structural brain abnormalities in frontolimbic areas, comparable to, but less extensive than those reported in established schizophrenia. However, most available data come from ARMS samples from Australia, Europe, and North America while large studies from other populations are missing. We conducted a structural brain magnetic resonance imaging study from a relatively large sample of 69 ARMS individuals and 32 matched healthy controls (HC) recruited from Singapore as part of the Longitudinal Youth At-Risk Study (LYRIKS). We used 2 complementary approaches: a voxel-based morphometry and a surface-based morphometry analysis to extract regional gray and white matter volumes (GMV and WMV) and cortical thickness (CT). At the whole-brain level, we did not find any statistically significant difference between ARMS and HC groups concerning total GMV and WMV or regional GMV, WMV, and CT. The additional comparison of 2 regions of interest, hippocampal, and ventricular volumes, did not return any significant difference either. Several characteristics of the LYRIKS sample like Asian origins or the absence of current illicit drug use could explain, alone or in conjunction, the negative findings and suggest that there may be no dramatic volumetric or CT abnormalities in ARMS.
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Affiliation(s)
- Paul Klauser
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,Monash Clinical and Imaging Neuroscience, School of Psychological Sciences & Monash Biomedical Imaging, Monash University, Clayton, Australia;,These authors contributed equally to the article
| | - Juan Zhou
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore;
| | - Joseph K.W. Lim
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Joann S. Poh
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Hui Zheng
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Han Ying Tng
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Ranga Krishnan
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Jimmy Lee
- Department of General Psychiatry 1 and Research Division, Institute of Mental Health, Singapore, Singapore;,Office of Clinical Sciences, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Richard S.E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
| | - R. Alison Adcock
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC;,Center for Cognitive Neuroscience, Duke University, Durham, NC
| | - Stephen J. Wood
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,School of Psychology, University of Birmingham, Edgbaston, UK
| | - Alex Fornito
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Australia;,Monash Clinical and Imaging Neuroscience, School of Psychological Sciences & Monash Biomedical Imaging, Monash University, Clayton, Australia
| | - Michael W.L. Chee
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
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Cole JH, Filippetti ML, Allin MPG, Walshe M, Nam KW, Gutman BA, Murray RM, Rifkin L, Thompson PM, Nosarti C. Subregional Hippocampal Morphology and Psychiatric Outcome in Adolescents Who Were Born Very Preterm and at Term. PLoS One 2015; 10:e0130094. [PMID: 26091104 PMCID: PMC4474892 DOI: 10.1371/journal.pone.0130094] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 05/15/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The hippocampus has been reported to be structurally and functionally altered as a sequel of very preterm birth (<33 weeks gestation), possibly due its vulnerability to hypoxic-ischemic damage in the neonatal period. We examined hippocampal volumes and subregional morphology in very preterm born individuals in mid- and late adolescence and their association with psychiatric outcome. METHODS Structural brain magnetic resonance images were acquired at two time points (baseline and follow-up) from 65 ex-preterm adolescents (mean age = 15.5 and 19.6 years) and 36 term-born controls (mean age=15.0 and 19.0 years). Hippocampal volumes and subregional morphometric differences were measured from manual tracings and with three-dimensional shape analysis. Psychiatric outcome was assessed with the Rutter Parents' Scale at baseline, the General Health Questionnaire at follow-up and the Peters Delusional Inventory at both time points. RESULTS In contrast to previous studies we did not find significant difference in the cross-sectional or longitudinal hippocampal volumes between individuals born preterm and controls, despite preterm individual having significantly smaller whole brain volumes. Shape analysis at baseline revealed subregional deformations in 28% of total bilateral hippocampal surface, reflecting atrophy, in ex-preterm individuals compared to controls, and in 22% at follow-up. In ex-preterm individuals, longitudinal changes in hippocampal shape accounted for 11% of the total surface, while in controls they reached 20%. In the whole sample (both groups) larger right hippocampal volume and bilateral anterior surface deformations at baseline were associated with delusional ideation scores at follow-up. CONCLUSIONS This study suggests a dynamic association between cross-sectional hippocampal volumes, longitudinal changes and surface deformations and psychosis proneness.
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Affiliation(s)
- James H. Cole
- The Computational, Cognitive & Clinical Neuroimaging Laboratory, Department of Medicine, Imperial College London, Burlington Danes Building, Du Cane Road, London, United Kingdom
| | - Maria Laura Filippetti
- Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, De Crespigny Park, London, United Kingdom
| | - Matthew P. G. Allin
- Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, De Crespigny Park, London, United Kingdom
| | - Muriel Walshe
- Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, De Crespigny Park, London, United Kingdom
| | - Kie Woo Nam
- Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, De Crespigny Park, London, United Kingdom
| | - Boris A. Gutman
- Imaging Genetics Center, University of Southern California, 4676 Admiralty Way, Marina del Rey, California, United States of America
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, De Crespigny Park, London, United Kingdom
| | - Larry Rifkin
- Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, De Crespigny Park, London, United Kingdom
| | - Paul M. Thompson
- Imaging Genetics Center, University of Southern California, 4676 Admiralty Way, Marina del Rey, California, United States of America
| | - Chiara Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, De Crespigny Park, London, United Kingdom
- * E-mail:
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Bernard JA, Orr JM, Mittal VA. Abnormal hippocampal-thalamic white matter tract development and positive symptom course in individuals at ultra-high risk for psychosis. NPJ SCHIZOPHRENIA 2015; 1. [PMID: 26120591 PMCID: PMC4479398 DOI: 10.1038/npjschz.2015.9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background/Objectives: Abnormal development of the hippocampus has been reported in adolescents at ultra-high risk (UHR) for psychosis and thalamic abnormalities have been found. However, the white matter connections between the hippocampus and the thalamus have not been studied. The connections between these regions are of key importance to our understanding of the pathophysiology of psychosis. Methods: Twenty-six UHR and 21 healthy age-matched controls were tested at a baseline assessment and 12 months later. Symptoms were assessed at both the time points and all the participants underwent diffusion tensor imaging scans. We used tractography to trace the white matter connections in each individual between the thalamus and hippocampus and then extracted fractional anisotropy (FA) to assess white matter structural integrity. Results: There was a significant group by time interaction indicating that FA decreased in UHR, and increased in controls over 12 months. Across both groups, baseline FA of the thalamic–hippocampal tract was predictive of positive symptoms at 12-month follow-up. Critically, this pattern remained significant in UHR individual group alone. At baseline, those with higher FA, indicative of abnormal white matter development, show higher positive symptoms 1 year later. Conclusions: Here, we provide evidence to indicate that there are differences in white matter development in hippocampal–thalamic connections, both of which are important nodes in networks associated with schizophrenia. Furthermore, abnormal developmental patterns in UHR individuals are associated with positive symptom course.
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Affiliation(s)
- Jessica A Bernard
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Joseph M Orr
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Vijay A Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA ; Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
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32
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Harrisberger F, Smieskova R, Schmidt A, Lenz C, Walter A, Wittfeld K, Grabe HJ, Lang UE, Fusar-Poli P, Borgwardt S. BDNF Val66Met polymorphism and hippocampal volume in neuropsychiatric disorders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2015; 55:107-18. [PMID: 25956254 DOI: 10.1016/j.neubiorev.2015.04.017] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 04/15/2015] [Accepted: 04/25/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is a neurotrophin involved in neurogenesis and synaptic plasticity in the central nervous system, especially in the hippocampus, and has been implicated in the pathophysiology of several neuropsychiatric disorders. Its Val66Met polymorphism (refSNP Cluster Report: rs6265) is a functionally relevant single nucleotide polymorphism affecting the secretion of BDNF and is implicated in differences in hippocampal volumes. METHODS This is a systematic meta-analytical review of findings from imaging genetic studies on the impact of the rs6265 SNP on hippocampal volumes in neuropsychiatric patients with major depressive disorder, anxiety, bipolar disorder or schizophrenia. RESULTS The overall sample size of 18 independent clinical cohorts comprised 1695 patients. Our results indicated no significant association of left (Hedge's g=0.08, p=0.12), right (g=0.07, p=0.22) or bilateral (g=0.07, p=0.16) hippocampal volumes with BDNF rs6265 in neuropsychiatric patients. There was no evidence for a publication bias or any demographic, clinical, or methodological moderating effects. Both Val/Val homozygotes (g=0.32, p=0.004) and Met-carriers (g=0.20, p=0.004) from the patient sample had significantly smaller hippocampal volumes than the healthy control sample with the same allele. The magnitude of these effects did not differ between the two genotypes. CONCLUSION This meta-analysis suggests that there is no association between this BDNF polymorphism and hippocampal volumes. For each BDNF genotype, the hippocampal volumes were significantly lower in neuropsychiatric patients than in healthy controls.
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Affiliation(s)
- F Harrisberger
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - R Smieskova
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - A Schmidt
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - C Lenz
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - A Walter
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - K Wittfeld
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - H J Grabe
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Helios Hospital Stralsund, Stralsund, Germany
| | - U E Lang
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland
| | - P Fusar-Poli
- King's College London, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park 16, SE58AF London, UK; OASIS Prodromal Team SLaM NHS Foundation Trust, London, UK
| | - S Borgwardt
- University of Basel, Department of Psychiatry (UPK), Wilhelm Klein-Strasse 27, 4056 Basel, Switzerland; University of Basel, Department of Clinical Research (DKF), 4031 Basel, Switzerland; King's College London, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park 16, SE58AF London, UK.
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Abstract
INTRODUCTION Pituitary enlargement has been reported in individuals with schizophrenic psychosis or an at-risk mental state for psychosis (ARMS). In a previous study, our group could show pituitary volume increase in first episode and ARMS patients with later transition to psychosis (ARMS-T). However, there are no longitudinal studies on this issue so far. We therefore examined longitudinally whether transition to psychosis would be accompanied by a further increase of pituitary volume in antipsychotic-naïve ARMS patients. METHODS Magnetic resonance imaging (MRI) data were acquired from 23 antipsychotic-naïve individuals with an ARMS. Ten subjects developed psychosis (ARMS-T) and 13 did not (ARMS-NT). ARMS-T were re-scanned after the onset of psychosis, and ARMS-NT were re-scanned at the end of the study period. RESULTS There was no significant difference of the pituitary volume between ARMS-T and ARMS-NT in our sample, and there were no significant pituitary volume changes over time. Discussion Longitudinally, we could not detect any further volumetric changes in the pituitary volume with transition to psychosis. CONCLUSIONS This, together with the result of our previous study, could indicate that the perceived level of stress in ARMS patients is constantly high from very early onward.
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Much ado about much: stress, dynamic biomarkers and HPA axis dysregulation along the trajectory to psychosis. Schizophr Res 2015; 162:253-60. [PMID: 25620122 DOI: 10.1016/j.schres.2015.01.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 01/01/2015] [Accepted: 01/05/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVES In the context of a stress-vulnerability framework, hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis is thought contribute to the risk, onset and course of psychotic illness. However, recent reports regarding static and dynamic features of the HPA axis suggest a more complex set of phenomena at play in the early phases of psychosis. METHODS We review literature regarding structural and functional aspects of the HPA axis in subjects at risk for or experiencing the first episode of psychosis, including evidence favoring as well as that which contradicts a model of HPA axis hyperactivation. RESULTS Static measures of diurnal cortisol and hippocampal/pituitary volumes suggest that the HPA axis is in a hyperactivated state in early phases of psychosis. In contrast, the dynamic cortisol response to encountered or anticipated stress is blunted in the same populations. These incongruent findings need to be better understood. CONCLUSIONS We consider potential explanations for the seemingly contradictory elevation and blunting of HPA biomarkers in the early course of psychosis. Finally, we propose and explore implications of a conceptual model of tonic HPA hyperactivation and phasic HPA blunting that integrates and reconciles these data.
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Reniers RLEP, Garner B, Phassouliotis C, Phillips LJ, Markulev C, Pantelis C, Bendall S, McGorry PD, Wood SJ. The relationship between stress, HPA axis functioning and brain structure in first episode psychosis over the first 12 weeks of treatment. Psychiatry Res 2015; 231:111-9. [PMID: 25492856 DOI: 10.1016/j.pscychresns.2014.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 10/24/2014] [Accepted: 11/06/2014] [Indexed: 12/20/2022]
Abstract
Stress and abnormal hypothalamic-pituitary-adrenal axis functioning have been implicated in the early phase of psychosis and may partly explain reported changes in brain structure. This study used magnetic resonance imaging to investigate whether biological measures of stress were related to brain structure at baseline and to structural changes over the first 12 weeks of treatment in first episode patients (n=22) compared with matched healthy controls (n=22). At baseline, no significant group differences in biological measures of stress, cortical thickness or hippocampal volume were observed, but a significantly stronger relationship between baseline levels of cortisol and smaller white matter volumes of the cuneus and anterior cingulate was found in patients compared with controls. Over the first 12 weeks of treatment, patients showed a significant reduction in thickness of the posterior cingulate compared with controls. Patients also showed a significant positive relationship between baseline cortisol and increases in hippocampal volume over time, suggestive of brain swelling in association with psychotic exacerbation, while no such relationship was observed in controls. The current findings provide some support for the involvement of stress mechanisms in the pathophysiology of early psychosis, but the changes are subtle and warrant further investigation.
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Affiliation(s)
- Renate L E P Reniers
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
| | - Belinda Garner
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia
| | - Christina Phassouliotis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Lisa J Phillips
- Psychological Sciences, University of Melbourne, Redmond Barry Building, Parkville, Victoria 3010, Australia
| | - Connie Markulev
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia
| | - Stephen J Wood
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3053, Australia
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Bois C, Whalley HC, McIntosh AM, Lawrie SM. Structural magnetic resonance imaging markers of susceptibility and transition to schizophrenia: a review of familial and clinical high risk population studies. J Psychopharmacol 2015; 29:144-54. [PMID: 25049260 DOI: 10.1177/0269881114541015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is a growing consensus that a symptomatology as complex and heterogeneous as schizophrenia is likely to be produced by widespread perturbations of brain structure, as opposed to isolated deficits in specific brain regions. Structural brain-imaging studies have shown that several features of the brain, such as grey matter, white matter integrity and the morphology of the cortex differ in individuals at high risk of the disorder compared to controls, but to a lesser extent than in patients, suggesting that structural abnormalities may form markers of vulnerability to the disorder. Research has had some success in delineating abnormalities specific to those individuals that transition to psychosis, compared to those at high risk that do not, suggesting that a general risk for the disorder can be distinguished from alterations specific to frank psychosis. In this paper, we review cross-sectional and longitudinal studies of individuals at familial or clinical high risk of the disorder. We conclude that the search for reliable markers of schizophrenia is likely to be enhanced by methods which amalgamate structural neuroimaging data into a coherent framework that takes into account the widespread distribution of brain alterations, and relates this to leading hypotheses of schizophrenia.
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Affiliation(s)
- C Bois
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S M Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
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Pruessner M, Lepage M, Collins DL, Pruessner JC, Joober R, Malla AK. Reduced hippocampal volume and hypothalamus-pituitary-adrenal axis function in first episode psychosis: evidence for sex differences. NEUROIMAGE-CLINICAL 2014; 7:195-202. [PMID: 25610781 PMCID: PMC4300007 DOI: 10.1016/j.nicl.2014.12.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/31/2014] [Accepted: 12/01/2014] [Indexed: 01/01/2023]
Abstract
Background Hippocampal volume (HV) decline is an important marker of psychosis and has been associated with hypothalamus–pituitary–adrenal (HPA) axis dysregulation in various disorders. Given recent findings of sex differences in HPA axis function in psychosis, the current study investigated differences in HV in male and female first episode psychosis (FEP) patients and controls and the interaction of HV with the cortisol awakening response (CAR) and symptoms. Methods Fifty-eight patients with a diagnosis of FEP (39 men, 19 women) and 27 healthy community controls (15 men, 12 women) underwent structural magnetic resonance imaging (MRI) on a 1.5 T scanner. Hippocampal volume was determined using previously established segmentation protocols. Saliva samples for cortisol assessment were collected at 0, 30 and 60 min after awakening. Psychotic symptoms were assessed with the Scale for Assessment of Positive Symptoms (SAPS), the Scale for Assessment of Negative Symptoms (SANS) and the Global Assessment of Functioning (GAF) scale. Results Male patients had significantly smaller left and right HVs compared to male controls, which appeared to be secondary to global brain volume differences. However, even when controlling for overall brain size, male patients showed smaller HV compared to female patients. The CAR was significantly lower in male patients compared to male controls and female patients. Only in male patients, smaller left HV was significantly associated with a blunted CAR, and smaller HV bilaterally was related to positive psychotic symptoms and lower levels of functioning. Conclusions We propose that reduced hippocampal volume and an attenuated cortisol awakening response are related markers of increased stress vulnerability in male psychosis patients and that both contribute to the unfavorable clinical picture in men. We examined sex differences in neurobiological markers of stress in psychosis. Hippocampal volume and cortisol levels to awakening are reduced in male patients. Male first episode psychosis patients show markers of high stress vulnerability. Neurobiological deficits relate to poor outcome in male but not female patients. The neural-diathesis stress model of schizophrenia is particularly valid for men.
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Affiliation(s)
- Marita Pruessner
- Department of Psychiatry, Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Martin Lepage
- Department of Psychiatry, Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Jens C Pruessner
- Department of Psychiatry, McGill Centre for Studies in Aging, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Ridha Joober
- Department of Psychiatry, Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Ashok K Malla
- Department of Psychiatry, Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
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McGorry P, Keshavan M, Goldstone S, Amminger P, Allott K, Berk M, Lavoie S, Pantelis C, Yung A, Wood S, Hickie I. Biomarkers and clinical staging in psychiatry. World Psychiatry 2014; 13:211-23. [PMID: 25273285 PMCID: PMC4219053 DOI: 10.1002/wps.20144] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Personalized medicine is rapidly becoming a reality in today's physical medicine. However, as yet this is largely an aspirational goal in psychiatry, despite significant advances in our understanding of the biochemical, genetic and neurobiological processes underlying major mental disorders. Preventive medicine relies on the availability of predictive tools; in psychiatry we still largely lack these. Furthermore, our current diagnostic systems, with their focus on well-established, largely chronic illness, do not support a pre-emptive, let alone a preventive, approach, since it is during the early stages of a disorder that interventions have the potential to offer the greatest benefit. Here, we present a clinical staging model for severe mental disorders and discuss examples of biological markers that have already undergone some systematic evaluation and that could be integrated into such a framework. The advantage of this model is that it explicitly considers the evolution of psychopathology during the development of a mental illness and emphasizes that progression of illness is by no means inevitable, but can be altered by providing appropriate interventions that target individual modifiable risk and protective factors. The specific goals of therapeutic intervention are therefore broadened to include the prevention of illness onset or progression, and to minimize the risk of harm associated with more complex treatment regimens. The staging model also facilitates the integration of new data on the biological, social and environmental factors that influence mental illness into our clinical and diagnostic infrastructure, which will provide a major step forward in the development of a truly pre-emptive psychiatry.
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Affiliation(s)
- Patrick McGorry
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Centre, Harvard Medical SchoolBoston, MA, USA
| | - Sherilyn Goldstone
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Paul Amminger
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Kelly Allott
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Michael Berk
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia,School of Medicine, Deakin UniversityGeelong, Australia
| | - Suzie Lavoie
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, MelbourneAustralia
| | - Alison Yung
- Institute of Brain, Behaviour and Mental Health, University of Manchester, ManchesterUK
| | - Stephen Wood
- School of Psychology, University of Birmingham, BirminghamUK
| | - Ian Hickie
- Brain and Mind Research Institute, University of Sydney, SydneyAustralia
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Song X, Fan X, Li X, Kennedy D, Pang L, Quan M, Chen X, Gao J, Zhang W, Zhang J, Lv L. Serum levels of BDNF, folate and homocysteine: in relation to hippocampal volume and psychopathology in drug naïve, first episode schizophrenia. Schizophr Res 2014; 159:51-5. [PMID: 25128453 DOI: 10.1016/j.schres.2014.07.033] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/15/2014] [Accepted: 07/25/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The present study was to examine serum levels of brain-derived neurotrophic factor (BDNF), folate, homocysteine (Hcy), and their relationships with hippocampal volume and psychopathology in drug naïve, first episode schizophrenia. METHOD Drug naïve, first episode schizophrenia patients and healthy controls were enrolled in the study. Serum levels of BDNF, folate and Hcy were measured using enzyme-linked immunosorbent assay (ELISA), electrochemiluminescence immunoassay (ECLIA), and enzymatic cycling method respectively. Hippocampus was parcellated and bilateral hippocampal volumes were measured using FreeSurfer. RESULTS Forty-six patients with drug naïve, first episode schizophrenia (SZ group) and 30 healthy controls (control group) were enrolled. The SZ group had significantly lower serum levels of BDNF and folate, and significantly higher serum levels of Hcy compared with the control group (p=0.013, p<0.001, p=0.003 respectively). There were no significant differences in hippocampal volumes between the two groups (ps>0.2). Within the SZ group, there were significant positive relationships between serum levels of BDNF and both left and right hippocampal volumes (r=0.327, p=0.026; r=0.338, p=0.022 respectively). In contrast, such relationships did not exist in the control group. Within the SZ group, there were significant negative relationships between serum levels of folate and PANSS-total scores and PANSS-negative symptom scores (r=0.319, p=0.031; r=0.321, p=0.030 respectively); and there was a positive relationship between serum levels of Hcy and PANSS-total scores (r=0.312, p=0.035). Controlling for potential confounding variables resulted in similar findings. CONCLUSIONS Drug naïve, first episode schizophrenia presents decreased serum levels of BDNF, folate and increased serum levels of Hcy, which may play an important role in the neurodevelopmental process and clinical manifestation of schizophrenia.
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Affiliation(s)
- Xueqin Song
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Henan Province Biological Psychiatry Key Laboratory, Xinxiang Medical University, Xinxiang, China; Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Xiaoduo Fan
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Xue Li
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - David Kennedy
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lijuan Pang
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Meina Quan
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Xumei Chen
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Jinsong Gao
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Wei Zhang
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Jianjiang Zhang
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China
| | - Luxian Lv
- Henan Province Biological Psychiatry Key Laboratory, Xinxiang Medical University, Xinxiang, China; Henan Province Mental Hospital, The Second Affiliated Hospital/Xinxiang Medical University, Xinxiang, China.
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Ganzola R, Maziade M, Duchesne S. Hippocampus and amygdala volumes in children and young adults at high-risk of schizophrenia: research synthesis. Schizophr Res 2014; 156:76-86. [PMID: 24794883 DOI: 10.1016/j.schres.2014.03.030] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 03/25/2014] [Accepted: 03/27/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Studies have reported hippocampal and amygdala volume abnormalities in schizophrenic patients. It is necessary to explore the potential for these structures as early disease markers in subjects at high risk (HR) of schizophrenia. METHODS We performed a review of 29 magnetic resonance imaging (MRI) studies measuring hippocampal and amygdala volumes in subjects at HR for schizophrenia. We reclassified subjects in 3 new HR categories: presence of only risk symptoms (psychotic moderate symptoms), presence of only risk factors (genetic, developmental or environmental), and presence of combined risk symptoms/factors. RESULTS Hippocampal volume reductions were detected in subjects with first episode (FE) of psychosis, in all young adults and in adolescents at HR of schizophrenia. The loss of tissue was mainly located in the posterior part of hippocampus and the right side seems more vulnerable in young adults with only risk symptoms. Instead, the anterior sector seems more involved in HR subjects with genetic risks. Abnormal amygdala volumes were found in FE subjects, in children with combined risk symptoms/factors and in older subjects using different inclusion criteria, but not in young adults. CONCLUSION Hippocampal and amygdala abnormalities may be present before schizophrenia onset. Further studies should be conducted to clarify whether these abnormalities are causally or effectually related to neurodevelopment. Shape analysis could clarify the impact of environmental, genetic, and developmental factors on the medial temporal structures during the evolution of this disease.
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Affiliation(s)
- Rossana Ganzola
- Institut universitaire en santé mentale de Québec, Québec, Canada.
| | - Michel Maziade
- Institut universitaire en santé mentale de Québec, Québec, Canada; Département de Psychiatrie et Neurosciences, Faculté de Médecine, Université Laval, Québec, Canada
| | - Simon Duchesne
- Institut universitaire en santé mentale de Québec, Québec, Canada; Départment de Radiologie, Faculté de Médecine, Université Laval, Québec, Canada
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41
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Neurodegenerative Aspects in Vulnerability to Schizophrenia Spectrum Disorders. Neurotox Res 2014; 26:400-13. [DOI: 10.1007/s12640-014-9473-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 04/21/2014] [Accepted: 04/21/2014] [Indexed: 01/20/2023]
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Tognin S, Riecher-Rössler A, Meisenzahl EM, Wood SJ, Hutton C, Borgwardt SJ, Koutsouleris N, Yung AR, Allen P, Phillips LJ, McGorry PD, Valli I, Velakoulis D, Nelson B, Woolley J, Pantelis C, McGuire P, Mechelli A. Reduced parahippocampal cortical thickness in subjects at ultra-high risk for psychosis. Psychol Med 2014; 44:489-498. [PMID: 23659473 PMCID: PMC3880065 DOI: 10.1017/s0033291713000998] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 04/06/2013] [Accepted: 04/11/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Grey matter volume and cortical thickness represent two complementary aspects of brain structure. Several studies have described reductions in grey matter volume in people at ultra-high risk (UHR) of psychosis; however, little is known about cortical thickness in this group. The aim of the present study was to investigate cortical thickness alterations in UHR subjects and compare individuals who subsequently did and did not develop psychosis. METHOD We examined magnetic resonance imaging data collected at four different scanning sites. The UHR subjects were followed up for at least 2 years. Subsequent to scanning, 50 UHR subjects developed psychosis and 117 did not. Cortical thickness was examined in regions previously identified as sites of neuroanatomical alterations in UHR subjects, using voxel-based cortical thickness. RESULTS At baseline UHR subjects, compared with controls, showed reduced cortical thickness in the right parahippocampal gyrus (p < 0.05, familywise error corrected). There were no significant differences in cortical thickness between the UHR subjects who later developed psychosis and those who did not. CONCLUSIONS These data suggest that UHR symptomatology is characterized by alterations in the thickness of the medial temporal cortex. We did not find evidence that the later progression to psychosis was linked to additional alterations in cortical thickness, although we cannot exclude the possibility that the study lacked sufficient power to detect such differences.
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Affiliation(s)
- S. Tognin
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - A. Riecher-Rössler
- Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, c/o University Hospital Basel, Petersgraben, Basel, Switzerland
| | - E. M. Meisenzahl
- Departments of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - S. J. Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
- School of Psychology, University of Birmingham, Birmingham, UK
| | - C. Hutton
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, UK
| | - S. J. Borgwardt
- Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, c/o University Hospital Basel, Petersgraben, Basel, Switzerland
| | - N. Koutsouleris
- Departments of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - A. R. Yung
- Orygen Research Centre, University of Melbourne, Victoria, Australia
| | - P. Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - L. J. Phillips
- Psychological Sciences, University of Melbourne, Victoria, Australia
| | - P. D. McGorry
- Orygen Research Centre, University of Melbourne, Victoria, Australia
| | - I. Valli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - D. Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - B. Nelson
- Orygen Research Centre, University of Melbourne, Victoria, Australia
| | - J. Woolley
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - C. Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - P. McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - A. Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
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Cannabis use and brain structural alterations of the cingulate cortex in early psychosis. Psychiatry Res 2013; 214:102-8. [PMID: 24054726 DOI: 10.1016/j.pscychresns.2013.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 06/13/2013] [Accepted: 06/14/2013] [Indexed: 02/07/2023]
Abstract
As cannabis use is more frequent in patients with psychosis than in the general population and is known to be a risk factor for psychosis, the question arises whether cannabis contributes to recently detected brain volume reductions in schizophrenic psychoses. This study is the first to investigate how cannabis use is related to the cingulum volume, a brain region involved in the pathogenesis of schizophrenia, in a sample of both at-risk mental state (ARMS) and first episode psychosis (FEP) subjects. A cross-sectional magnetic resonance imaging (MRI) study of manually traced cingulum in 23 FEP and 37 ARMS subjects was performed. Cannabis use was assessed with the Basel Interview for Psychosis. By using repeated measures analyses of covariance, we investigated whether current cannabis use is associated with the cingulum volume, correcting for age, gender, alcohol consumption, whole brain volume and antipsychotic medication. There was a significant three-way interaction between region (anterior/posterior cingulum), hemisphere (left/right cingulum) and cannabis use (yes/no). Post-hoc analyses revealed that this was due to a significant negative effect of cannabis use on the volume of the posterior cingulum which was independent of the hemisphere and diagnostic group and all other covariates we controlled for. In the anterior cingulum, we found a significant negative effect only for the left hemisphere, which was again independent of the diagnostic group. Overall, we found negative associations of current cannabis use with grey matter volume of the cingulate cortex, a region rich in cannabinoid CB1 receptors. As this finding has not been consistently found in healthy controls, it might suggest that both ARMS and FEP subjects are particularly sensitive to exogenous activation of these receptors.
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Schulz KM, Andrud KM, Burke MB, Pearson JN, Kreisler AD, Stevens KE, Leonard S, Adams CE. The effects of prenatal stress on alpha4 beta2 and alpha7 hippocampal nicotinic acetylcholine receptor levels in adult offspring. Dev Neurobiol 2013; 73:806-14. [PMID: 23749479 PMCID: PMC4438756 DOI: 10.1002/dneu.22097] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 04/26/2013] [Accepted: 05/20/2013] [Indexed: 12/17/2022]
Abstract
Prenatal stress in humans is associated with psychiatric problems in offspring such as anxiety, depression, and schizophrenia. These same illnesses are also associated with neuronal nicotinic acetylcholine receptor (nAChR) dysfunction. Despite the known associations between prenatal stress exposure and offspring mental illness, and between mental illness and nAChR dysfunction, it is not known whether prenatal stress exposure impacts neuronal nAChRs. Thus, we tested the hypothesis that maternal stress alters the development of hippocampal alpha4 beta2 (α4β2∗) and alpha7 (α7∗) nicotinic receptor levels in adult offspring. Female Sprague-Dawley rats experienced unpredictable variable stressors two to three times daily during the last week of gestation. At weaning (21 days) the offspring of prenatally stressed (PS) and nonstressed (NS) dams were assigned to same-sex PS or NS groups. In young adulthood (56 days), the brains of offspring were collected and adjacent sections processed for quantitative autoradiography using [125I]-epibatidine (α4β2* nicotinic receptor-selective) and [125I]-α-bungarotoxin (α-BTX; α7* nicotinic receptor-selective) ligands. We found that PS significantly increased hippocampal α4β2* nAChRs of males and females in all subfields analyzed. In contrast, only females showed a trend toward PS-induced increases in α7* nAChRs in the dentate gyrus. Interestingly, NS females displayed a significant left-biased lateralization of α7* nAChRs in the laconosum moleculare of area CA1, whereas PS females did not, suggesting that PS interfered with normal lateralization patterns of α7* nAChRs during development. Taken together, our results suggest that PS impacts the development of hippocampal nAChRs, which may be an important link between PS exposure and risk for neuropsychiatric illness.
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Affiliation(s)
- Kalynn M Schulz
- Veterans Affairs Medical Center, Denver, Colorado; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Colorado
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Brent BK, Thermenos HW, Keshavan MS, Seidman LJ. Gray Matter Alterations in Schizophrenia High-Risk Youth and Early-Onset Schizophrenia: A Review of Structural MRI Findings. Child Adolesc Psychiatr Clin N Am 2013; 22:689-714. [PMID: 24012081 PMCID: PMC3767930 DOI: 10.1016/j.chc.2013.06.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article reviews the literature on structural magnetic resonance imaging findings in pediatric and young adult populations at clinical or genetic high-risk for schizophrenia and early-onset schizophrenia. The implications of this research are discussed for understanding the pathophysiology of schizophrenia and for early intervention strategies. The evidence linking brain structural changes in prepsychosis development and early-onset schizophrenia with disruptions of normal neurodevelopmental processes during childhood or adolescence is described. Future directions are outlined for research to address knowledge gaps regarding the neurobiological basis of brain structural abnormalities in schizophrenia and to improve the usefulness of these abnormalities for preventative interventions.
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Affiliation(s)
- Benjamin K Brent
- Harvard Medical School, Boston, MA 02115, USA; Division of Public Psychiatry, Massachusetts Mental Health Center, 75 Fenwood Road, Boston, MA 02115, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
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46
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Vitacco MJ, Buckley PF. Substance Use Comorbidity in Patients with Schizophrenia. Psychiatr Ann 2013. [DOI: 10.3928/00485713-20131003-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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47
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Lunsford-Avery JR, Mittal VA. Sleep dysfunction prior to the onset of schizophrenia: A review and neurodevelopmental diathesis–stress conceptualization. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/cpsp.12041] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Tognin S, Pettersson-Yeo W, Valli I, Hutton C, Woolley J, Allen P, McGuire P, Mechelli A. Using structural neuroimaging to make quantitative predictions of symptom progression in individuals at ultra-high risk for psychosis. Front Psychiatry 2013; 4:187. [PMID: 24523700 PMCID: PMC3905239 DOI: 10.3389/fpsyt.2013.00187] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 12/24/2013] [Indexed: 12/23/2022] Open
Abstract
Neuroimaging holds the promise that it may one day aid the clinical assessment of individual psychiatric patients. However, the vast majority of studies published so far have been based on average differences between groups, which do not permit accurate inferences at the level of the individual. We examined the potential of structural Magnetic Resonance Imaging (MRI) data for making accurate quantitative predictions about symptom progression in individuals at ultra-high risk for developing psychosis. Forty people at ultra-high risk for psychosis were scanned using structural MRI at first clinical presentation and assessed over a period of 2 years using the Positive and Negative Syndrome Scale. Using a multivariate machine learning method known as relevance vector regression (RVR), we examined the relationship between brain structure at first clinical presentation, characterized in terms of gray matter (GM) volume and cortical thickness (CT), and symptom progression at 2-year follow-up. The application of RVR to whole-brain CT MRI data allowed quantitative prediction of clinical scores with statistically significant accuracy (correlation = 0.34, p = 0.026; Mean Squared-Error = 249.63, p = 0.024). This prediction was informed by regions traditionally associated with schizophrenia, namely the right lateral and medial temporal cortex and the left insular cortex. In contrast, the application of RVR to GM volume did not allow prediction of symptom progression with statistically significant accuracy. These results provide proof-of-concept that it could be possible to use structural MRI to inform quantitative prediction of symptom progression in individuals at ultra-high risk of developing psychosis. This would enable clinicians to target those individuals at greatest need of preventative interventions thereby resulting in a more efficient use of health care resources.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - William Pettersson-Yeo
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Isabel Valli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Chloe Hutton
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London , London , UK
| | - James Woolley
- Division of Experimental Medicine, Imperial College London , London , UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
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49
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Wood SJ, Reniers RLEP, Heinze K. Neuroimaging findings in the at-risk mental state: a review of recent literature. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2013; 58:13-8. [PMID: 23327751 DOI: 10.1177/070674371305800104] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The at-risk mental state (ARMS) has been the subject of much interest during the past 15 years. A great deal of effort has been expended to identify neuroimaging markers that can inform our understanding of the risk state and to help predict who will transition to frank psychotic illness. Recently, there has been an explosion of neuroimaging literature from people with an ARMS, which has meant that reviews and meta-analyses lack currency. Here we review papers published in the past 2 years, and contrast their findings with previous reports. While it is clear that people in the ARMS do show brain alterations when compared with healthy control subjects, there is an overall lack of consistency as to which of these alterations predict the development of psychosis. This problem arises because of variations in methodology (in patient recruitment, region of interest, method of analysis, and functional task employed), but there has also been too little effort put into replicating previous research. Nonetheless, there are areas of promise, notably that activation of the stress system and increased striatal dopamine synthesis seem to mark out patients in the ARMS most at risk for later transition. Future studies should focus on these areas, and on network-level analysis, incorporating graph theoretical approaches and intrinsic connectivity networks.
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Affiliation(s)
- Stephen J Wood
- Professor of Adolescent Brain Development and Mental Health, School of Psychology, University of Birmingham, Edgbaston, England.
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50
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Hall T, Galletly C, Clark CR, Veltmeyer M, Metzger LJ, Gilbertson MW, Orr SP, Pitman RK, McFarlane A. The relationship between Hippocampal asymmetry and working memory processing in combat-related PTSD - a monozygotic twin study. BIOLOGY OF MOOD & ANXIETY DISORDERS 2012; 2:21. [PMID: 23198722 PMCID: PMC3582553 DOI: 10.1186/2045-5380-2-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 09/24/2012] [Indexed: 11/10/2022]
Abstract
UNLABELLED BACKGROUND PTSD is associated with reduction in hippocampal volume and abnormalities in hippocampal function. Hippocampal asymmetry has received less attention, but potentially could indicate lateralised differences in vulnerability to trauma. The P300 event-related potential component reflects the immediate processing of significant environmental stimuli and has generators in several brain regions including the hippocampus. P300 amplitude is generally reduced in people with PTSD. METHODS Our study examined hippocampal volume asymmetry and the relationship between hippocampal asymmetry and P300 amplitude in male monozygotic twins discordant for Vietnam combat exposure. Lateralised hippocampal volume and P300 data were obtained from 70 male participants, of whom 12 had PTSD. We were able to compare (1) combat veterans with current PTSD; (2) their non-combat-exposed co-twins; (3) combat veterans without current PTSD and (4) their non-combat-exposed co-twins. RESULTS There were no significant differences between groups in hippocampal asymmetry. There were no group differences in performance of an auditory oddball target detection task or in P300 amplitude. There was a significant positive correlation between P300 amplitude and the magnitude of hippocampal asymmetry in participants with PTSD. CONCLUSIONS These findings suggest that greater hippocampal asymmetry in PTSD is associated with a need to allocate more attentional resources when processing significant environmental stimuli.
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Affiliation(s)
- Timothy Hall
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, Australia
- Ramsay Health Care (SA) Mental Health Services, Adelaide, South Australia
- Northern Mental Health, Adelaide Metro Mental Health Directorate, Adelaide, South Australia
| | - C Richard Clark
- Cognitive Neuroscience Laboratory and School of Psychology, Flinders University of South Australia, Adelaide, Australia
| | - Melinda Veltmeyer
- Veterans Affairs Medical Centre Research Service, Manchester, New Hampshire, England
- Harvard Medical School, Boston, USA
| | | | - Mark W Gilbertson
- Veterans Affairs Medical Centre Research Service, Manchester, New Hampshire, England
| | - Scott P Orr
- Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Roger K Pitman
- Massachusetts General Hospital and Harvard Medical School, Boston, USA
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