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Lang X, Wang D, Zhou H, Wang L, Kosten TR, Zhang XY. P50 inhibition defects, psychopathology and gray matter volume in patients with first-episode drug-naive schizophrenia. Asian J Psychiatr 2023; 80:103421. [PMID: 36563611 DOI: 10.1016/j.ajp.2022.103421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/08/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sensory gating deficits and gray matter volume (GMV) abnormalities have been found to be associated with the pathogenesis and psychopathology of patients with schizophrenia (SCZ). However, no studies have investigated their interrelationship in first-episode treatment-naive (FETN) SCZ patients. METHODS We recruited 52 FETN SCZ patients and 57 healthy controls. The Positive and Negative Syndrome Scale (PANSS) was used to measure the psychopathology of the patients. We collected magnetic resonance imaging and P50 inhibition data from all participants. RESULTS Compared to healthy controls, patients had shorter S1 and S2 latencies but larger S2 amplitudes and P50 ratio (Bonferroni adjusted all p < 0.01). In patients, S2 latency was independently associated with PANSS total score, negative symptoms and general psychopathology (t = 2.26-2.58, both P < 0.05), whereas S1 (t = 2.44, P < 0.05) and S2 latencies (t = 2.13, P < 0.05) were associated with PANSS cognitive factor. Moreover, GMV in the left inferior temporal gyrus, left lingual gyrus and right superior occipital gyrus, and bilateral dorsolateral superior frontal gyrus were each associated with the P50 components (all p < 0.05). In addition, GMV associated with S2 latency was negatively correlated with PANSS general psychopathology (t = -2.46, p < 0.05) and total score (t = -2.34, p < 0.05). CONCLUSIONS Our findings indicate that FETN SCZ patients exhibit deficits in P50 inhibition and GMV of brain regions associated with these deficits may be associated with their psychopathological symptoms, suggesting that brain structures associated with P50 components may be important biomarkers of SCZ psychopathology. Future studies could use a prospective longitudinal design to investigate the potential causal relationship of brain structures associated with P50 components in the psychopathological symptoms of SCZ patients.
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Affiliation(s)
- XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China.
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Thomas R Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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2
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Ku BS, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Compton MT, Cornblatt BA, Druss BG, Keshavan M, Mathalon DH, Perkins DO, Stone WS, Tsuang MT, Woods SW, Walker EF. The associations between area-level residential instability and gray matter volumes from the North American Prodrome Longitudinal Study (NAPLS) consortium. Schizophr Res 2022; 241:1-9. [PMID: 35066429 PMCID: PMC8960350 DOI: 10.1016/j.schres.2021.12.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Area-level residential instability (ARI), an index of social fragmentation, has been shown to explain the association between urbanicity and psychosis. Urban upbringing has been shown to be associated with reduced gray matter volumes (GMV)s of brain regions corresponding to the right caudal middle frontal gyrus (CMFG) and rostral anterior cingulate cortex (rACC). We hypothesize that greater ARI will be associated with reduced right CMFG and rACC GMVs. METHODS Data were collected at baseline as part of the North American Prodrome Longitudinal Study Phase 2. Counties where participants resided during childhood were geographically coded using the US Census to area-level factors. ARI was defined as the percentage of residents living in a different house 5 years ago. Generalized linear mixed models tested associations between ARI and GMVs. RESULTS This study included 29 healthy controls (HC)s and 64 clinical high risk for psychosis (CHR-P) individuals who were aged 12 to 24 years, had remained in their baseline residential area, and had magnetic resonance imaging scans. ARI was associated with reduced right CMFG (adjusted β = -0.258; 95% CI = -0.502 to -0.015) and right rACC volumes (adjusted β = -0.318; 95% CI = -0.612 to -0.023). The interaction term (ARI-by-diagnostic group) in the prediction of both brain regions was not significant, indicating that the relationships between ARI and regional brain volumes held for both CHR-P and HCs. CONCLUSIONS ARI may adversely impact similar brain regions as urban upbringing. Further investigation into the potential mechanisms of the relationship between ARI and neurobiology, including social stress, is needed.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, United States
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; New York State Psychiatric Institute, New York, NY, United States
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, CA, United States; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ming T Tsuang
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
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Effects of adding a concurrent cognitive task on manual dexterity in people with schizophrenia: Implications for performance of daily life activities. Asian J Psychiatr 2020; 54:102456. [PMID: 33271735 DOI: 10.1016/j.ajp.2020.102456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 11/22/2022]
Abstract
This study investigated the effect of dual task performance of hand dexterity tasks and the relationship to daily functioning in 40 people with chronic schizophrenia and 35 healthy participants. Participants performed the Purdue Pegboard Test, O'Connor Finger Dexterity Test, and the Serial Subtracting Seven Task as the secondary task under single- and dual-task conditions and completed the Activities of Daily Living Rating Scale-III (ADLRS-III). The hand dexterity of all participants declined from the single to the dual tasks, and the discrepancy between single- and dual-task performance was significantly greater in the schizophrenia group than in the control group. Significant condition and group effects were found for both hand dexterity tests. People with schizophrenia who took longer time in performing hand dexterity tasks had significantly worse daily life function. Negative correlations were noted between discrepancy of dual tasking and the ADLRS-III score in the schizophrenic group. Deficits in dual-task performance of hand dexterity is significant in people with schizophrenia and is related to daily life performance. Occupational therapy practitioners can consider using dual tasks as a therapeutic activity for people with schizophrenia to promote functional abilities in real-world environments.
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Neuroanatomy of Patients with Deficit Schizophrenia: An Exploratory Quantitative Meta-Analysis of Structural Neuroimaging Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176227. [PMID: 32867189 PMCID: PMC7503710 DOI: 10.3390/ijerph17176227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 11/29/2022]
Abstract
Little is known regarding the neuroanatomical correlates of patients with deficit schizophrenia or persistent negative symptoms. In this meta-analysis, we aimed to determine whether patients with deficit schizophrenia have characteristic brain abnormalities. We searched PubMed, CINAHL and Ovid to identify studies that examined the various regions of interest amongst patients with deficit schizophrenia, patients with non-deficit schizophrenia and healthy controls. A total of 24 studies met our inclusion criteria. A random-effects model was used to calculate a combination of outcome measures, and heterogeneity was assessed by the I2 statistic and Cochran’s Q statistic. Our findings suggested that there was statistically significant reduction in grey matter volume (−0.433, 95% confidence interval (CI): −0.853 to −0.014, p = 0.043) and white matter volume (−0.319, 95% CI: −0.619 to −0.018, p = 0.038) in patients with deficit schizophrenia compared to healthy controls. There is also statistically significant reduction in total brain volume (−0.212, 95% CI: −0.384 to −0.041, p = 0.015) and white matter volume (−0.283, 95% CI: −0.546 to −0.021, p = 0.034) in patients with non-deficit schizophrenia compared to healthy controls. Between patients with deficit and non-deficit schizophrenia, there were no statistically significant differences in volumetric findings across the various regions of interest.
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Kim S, Kim YW, Jeon H, Im CH, Lee SH. Altered Cortical Thickness-Based Individualized Structural Covariance Networks in Patients with Schizophrenia and Bipolar Disorder. J Clin Med 2020; 9:jcm9061846. [PMID: 32545747 PMCID: PMC7356298 DOI: 10.3390/jcm9061846] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022] Open
Abstract
Structural covariance is described as coordinated variation in brain morphological features, such as cortical thickness and volume, among brain structures functionally or anatomically interconnected to one another. Structural covariance networks, based on graph theory, have been studied in mental disorders. This analysis can help in understanding the brain mechanisms of schizophrenia and bipolar disorder. We investigated cortical thickness-based individualized structural covariance networks in patients with schizophrenia and bipolar disorder. T1-weighted magnetic resonance images were obtained from 39 patients with schizophrenia, 37 patients with bipolar disorder type I, and 32 healthy controls, and cortical thickness was analyzed via a surface-based morphometry analysis. The structural covariance of cortical thickness was calculated at the individual level, and covariance networks were analyzed based on graph theoretical indices: strength, clustering coefficient (CC), path length (PL) and efficiency. At the global level, both patient groups showed decreased strength, CC and efficiency, and increased PL, compared to healthy controls. In bipolar disorder, we found intermediate network measures among the groups. At the nodal level, schizophrenia patients showed decreased CCs in the left suborbital sulcus and the right superior frontal sulcus, compared to bipolar disorder patients. In addition, patient groups showed decreased CCs in the right insular cortex and the left superior occipital gyrus. Global-level network indices, including strength, CCs and efficiency, positively correlated, while PL negatively correlated, with the positive symptoms of the Positive and Negative Syndrome Scale for patients with schizophrenia. The nodal-level CC of the right insular cortex positively correlated with the positive symptoms of schizophrenia, while that of the left superior occipital gyrus positively correlated with the Young Mania Rating Scale scores for bipolar disorder. Altered cortical structural networks were revealed in patients, and particularly, the prefrontal regions were more altered in schizophrenia. Furthermore, altered cortical structural networks in both patient groups correlated with core pathological symptoms, indicating that the insular cortex is more vulnerable in schizophrenia, and the superior occipital gyrus is more vulnerable in bipolar disorder. Our individualized structural covariance network indices might be promising biomarkers for the evaluation of patients with schizophrenia and bipolar disorder.
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Affiliation(s)
- Sungkean Kim
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA;
| | - Yong-Wook Kim
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Korea; (Y.-W.K.); (C.-H.I.)
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea;
| | - Hyeonjin Jeon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea;
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Korea; (Y.-W.K.); (C.-H.I.)
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang 411-706, Korea;
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Juhwa-ro 170, Ilsanseo-Gu, Goyang 411-706, Korea
- Correspondence: ; Tel.: +82-31-910-7260; Fax: +82-31-910-7268
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Xie T, Zhang X, Tang X, Zhang H, Yu M, Gong G, Wang X, Evans A, Zhang Z, He Y. Mapping Convergent and Divergent Cortical Thinning Patterns in Patients With Deficit and Nondeficit Schizophrenia. Schizophr Bull 2019; 45:211-221. [PMID: 29272543 PMCID: PMC6293229 DOI: 10.1093/schbul/sbx178] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Deficit schizophrenia (DS) is a homogeneous subtype of schizophrenia characterized by primary and enduring negative symptoms. However, the underlying neuroanatomical substrate of DS remains poorly understood. Here, we collected high-resolution structural magnetic resonance images of 115 participants, including 33 DS patients, 41 nondeficit schizophrenia (NDS) patients, and 41 healthy controls (HCs), and calculated the cortical thickness and surface area for statistical comparisons among the 3 groups. Relative to the control group, both the DS and NDS groups exhibited convergent cortical thinning in the bilateral inferior frontal gyri and the left superior temporal gyrus. The cortical thinning in the right inferior frontal cortex in the patient group was significantly positively correlated with declines of cognitive flexibility and visuospatial memory. Importantly, compared to the NDS group, the DS group exhibited a more widespread cortical thinning pattern, with the most significant differences in the left temporo-parietal junction area. For the surface area measurement, no significant group differences were observed. Collectively, these results highlight the convergent and divergent cortical thinning patterns between patients with DS and NDS, which provide critical insights into the neuroanatomical substrate of DS and improve our understanding of the biological mechanism that contributes to the negative symptoms and cognitive impairments in DS.
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Affiliation(s)
- Teng Xie
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China,Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xiaowei Tang
- Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, China
| | - Hongying Zhang
- Department of Radiology, Subei People’s Hospital of Jiangsu Province, Yangzhou University, Yangzhou, China
| | - Miao Yu
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Gaolang Gong
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiang Wang
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Alan Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Canada
| | - Zhijun Zhang
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yong He
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China,To whom correspondence should be addressed; National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Key Laboratory of Brain Imaging and Connectomics, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China. E-mail:
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7
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Jirsaraie RJ, Sheffield JM, Barch DM. Neural correlates of global and specific cognitive deficits in schizophrenia. Schizophr Res 2018; 201:237-242. [PMID: 29954699 PMCID: PMC6814153 DOI: 10.1016/j.schres.2018.06.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/14/2018] [Accepted: 06/09/2018] [Indexed: 12/12/2022]
Abstract
Cognitive deficits are a core feature of schizophrenia, but the neural mechanisms that contribute to these characteristics are not fully understood. This study investigated whether volume of the dorsal lateral prefrontal cortex (DLPFC), inferior frontal gyrus (IFG), hippocampus, and white matter were associated with impairment in specific cognitive domains, including executive functioning, working memory, verbal memory, verbal fluency, processing speed, versus global functioning. The multi-site data used in this study was collected from the Bipolar and Schizophrenia Network on Intermediate Phenotypes (B-SNIP), and consisted of 206 healthy controls and 247 individuals with either schizophrenia or schizoaffective disorder. The neuroimaging data was segmented based on the Destrieux atlas in FreeSurfer. Linear regression analyses revealed that global cognition, executive functioning, working memory, and processing speed were associated with all brain structures, except the DLPFC was only associated with executive fucntion. When controlling for the global cognitive deficit, executive function was trending significance with white matter, but continued to be associated with the DLPFC and IFG, as did the association between processing speed and the hippocampus. These findings suggest that volumes of the DLPFC, IFG, hippocampus, and white matter are associated with the global cognitive impairment seen in schizophrenia, but some brain structures may also be specifically related to domain-specific deficits (primarily executive function) over-and-beyond the global cognitive deficit.
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Affiliation(s)
- Robert J. Jirsaraie
- Department of Psychology, University of Colorado Denver, 1250 14th Street, Denver, CO, 80204, United States of America,Corresponding author. , (R.J. Jirsaraie)
| | - Julia M. Sheffield
- Department of Psychological&Brain Science, Washington University, Box 1125, One Brookings Drive, St. Louis, MO, 63130, United States of America
| | - Deanna M. Barch
- Department of Psychological&Brain Science, Washington University, Box 1125, One Brookings Drive, St. Louis, MO, 63130, United States of America,Department of Psychiatry, Washington University, Box 1125, One Brookings Drive, St Louis, MO, 63130, United States of America
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8
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İnce E, Üçok A. Relationship Between Persistent Negative Symptoms and Findings of Neurocognition and Neuroimaging in Schizophrenia. Clin EEG Neurosci 2018; 49:27-35. [PMID: 29243526 DOI: 10.1177/1550059417746213] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Negative symptoms are defined as loss or reduction of otherwise present behaviors or functions in illness situation, and they have constituted an important aspect of schizophrenia. Although negative symptoms have usually been considered as a single entity, neurobiological investigations yielded discrepant results. To overcome challenges that derive from this discrepancy, researchers have proposed several approaches to structure negative symptoms into more homogenous constructs. Concept of persistent negative symptoms (PNS) is one of the proposed approaches, and includes both primary and secondary negative symptoms that persist after adequate treatment. PNS is relatively easy to assess, and by definition, more inclusive; yet it represents an unmet therapeutic need. Therefore, it is a target of several neurobiological and pharmacological studies. There are several structural and functional brain alterations associated with negative symptoms. On the other hand, neurocognitive investigations in patients with schizophrenia have revealed deficits in several domains that showed correlations with negative symptoms. There are several shared features between negative symptoms and neurocognitive deficits in schizophrenia such as prevalence rates, course through the illness, prognostic importance, and impact on social functioning. However, exact mechanisms behind the neurobiology of PNS and how it interacts with neurocognition remain to be explained. Earlier reviews on neuroimaging and neurocognitive correlates of PNS have been focused on studies with broadly defined negative symptoms that were selected by methodological closeness to PNS. In this review, we focus on neural correlates and neurocognitive associations of PNS, and we discuss PNS findings available to date.
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Affiliation(s)
- Ezgi İnce
- 1 Department of Psychiatry, Faculty of Medicine, Istanbul University, Çapa, Istanbul, Turkey
| | - Alp Üçok
- 1 Department of Psychiatry, Faculty of Medicine, Istanbul University, Çapa, Istanbul, Turkey
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Seol JJ, Kim M, Lee KH, Hur JW, Cho KIK, Lee TY, Chung CK, Kwon JS. Is There an Association Between Mismatch Negativity and Cortical Thickness in Schizophrenia Patients? Clin EEG Neurosci 2017; 48:383-392. [PMID: 28612661 DOI: 10.1177/1550059417714705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Mismatch negativity (MMN) is thought to reflect preattentive, automatic auditory processing. Reduced MMN amplitude is among the most robust findings in schizophrenia research. MMN generators have been shown to be located in the temporal and frontal cortices, which are key areas in the pathophysiology of schizophrenia. This study investigated whether frontotemporal cortical thickness was associated with reduced MMN current source density (CSD) strength in patients with schizophrenia. METHODS Sixteen schizophrenia patients and 18 healthy controls (HCs) were examined using magnetoencephalography while they performed a passive auditory oddball paradigm. All participants underwent a T1 structural magnetic resonance imaging scan in a separate session. We evaluated MMN CSD and cortical thickness, and their associations, in the superior and transverse temporal gyri, as well as in the inferior and middle frontal gyri. RESULTS Patients exhibited significantly reduced CSD strength in all temporal and frontal areas of interest relative to HCs. There was a positive correlation between CSD strength and cortical thickness in both temporal and frontal areas in HCs. However, schizophrenia patients showed negative correlations between CSD strength and cortical thickness in the bilateral inferior frontal gyri. Additionally, we found positive correlations between frontal cortical thickness and negative and total scores on the Positive and Negative Syndrome Scale (PANSS). CONCLUSIONS Our findings provide evidence for deficient temporal and frontal MMN generators and a disruption of normal structure-function relationship in patients with schizophrenia.
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Affiliation(s)
- Jiyoon J Seol
- 1 Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Minah Kim
- 2 Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kwang Hyuk Lee
- 1 Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Ji-Won Hur
- 3 Department of Psychology, Chung-Ang University, Seoul, Republic of Korea
| | - Kang Ik K Cho
- 1 Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Tae Young Lee
- 2 Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chun Kee Chung
- 4 Magnetoencephalography Center, Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- 1 Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.,2 Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,5 Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
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Takahashi T, Takayanagi Y, Nishikawa Y, Nakamura M, Komori Y, Furuichi A, Kido M, Sasabayashi D, Noguchi K, Suzuki M. Brain neurodevelopmental markers related to the deficit subtype of schizophrenia. Psychiatry Res Neuroimaging 2017; 266:10-18. [PMID: 28549318 DOI: 10.1016/j.pscychresns.2017.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 03/29/2017] [Accepted: 05/19/2017] [Indexed: 02/02/2023]
Abstract
Deficit schizophrenia is a homogeneous subtype characterized by a trait-like feature of primary and prominent negative symptoms, but the etiologic factors related to this specific subtype remain largely unknown. This magnetic resonance imaging study aimed to examine gross brain morphology that probably reflects early neurodevelopment in 38 patients with deficit schizophrenia, 37 patients with non-deficit schizophrenia, and 59 healthy controls. Potential brain neurodevelopmental markers investigated in this study were the adhesio interthalamica (AI), cavum septi pellucidi (CSP), and surface morphology (i.e., olfactory sulcus depth, sulcogyral pattern, and number of orbital sulci) of the orbitofrontal cortex (OFC). The subtype classification of schizophrenia patients was based on the score of Proxy for the Deficit Syndrome. The deficit schizophrenia group had a significantly shorter AI compared with the non-deficit group and controls. The deficit group, but not the non-deficit group, was also characterized by an altered distribution of the OFC sulcogyral pattern, as well as fewer posterior orbital sulcus compared with controls. Other neurodevelopmental markers did not differentiate the deficit and non-deficit subgroups. These results suggest that the deficit subtype of schizophrenia and its clinical manifestation may be at least partly related to prominent neurodevelopmental pathology.
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Affiliation(s)
- Tsutomu Takahashi
- 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
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yuko Komori
- 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
| | - Daiki Sasabayashi
- 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
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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Mucci A, Merlotti E, Üçok A, Aleman A, Galderisi S. Primary and persistent negative symptoms: Concepts, assessments and neurobiological bases. Schizophr Res 2017; 186:19-28. [PMID: 27242069 DOI: 10.1016/j.schres.2016.05.014] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 05/10/2016] [Accepted: 05/17/2016] [Indexed: 02/01/2023]
Abstract
Primary and persistent negative symptoms (PPNS) represent an unmet need in the care of people with schizophrenia. They have an unfavourable impact on real-life functioning and do not respond to available treatments. Underlying etiopathogenetic mechanisms of PPNS are still unknown. The presence of primary and enduring negative symptoms characterizes deficit schizophrenia (DS), proposed as a separate disease entity with respect to non-deficit schizophrenia (NDS). More recently, to reduce the heterogeneity of negative symptoms by using criteria easily applicable in the context of clinical trials, the concept of persistent negative symptoms (PNS) was developed. Both PNS and DS constructs include enduring negative symptoms (at least 6months for PNS and 12months for DS) that do not respond to available treatments. PNS exclude secondary negative symptoms based on a cross-sectional evaluation of severity thresholds on commonly used rating scales for positive symptoms, depression and extrapyramidal side effects; the DS diagnosis, instead, excludes all potential sources of secondary negative symptoms based on a clinical longitudinal assessment. In this paper we review the evolution of concepts and assessment modalities relevant to PPNS, data on prevalence of DS and PNS, as well as studies on clinical, neuropsychological, brain imaging electrophysiological and psychosocial functioning aspects of DS and PNS.
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Affiliation(s)
- Armida Mucci
- Department of Psychiatry, University of Naples SUN, Naples, Italy.
| | | | - Alp Üçok
- Department of Psychiatry, Psychotic Disorders Research Program, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - André Aleman
- University of Groningen, University Medical Center Groningen, Department of Neuroscience and Department of Psychology, Groningen, The Netherlands
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Li Z, Lei W, Deng W, Zheng Z, Li M, Ma X, Wang Q, Huang C, Li N, Collier DA, Gong Q, Li T. Aberrant spontaneous neural activity and correlation with evoked-brain potentials in first-episode, treatment-naïve patients with deficit and non-deficit schizophrenia. Psychiatry Res Neuroimaging 2017; 261:9-19. [PMID: 28092779 DOI: 10.1016/j.pscychresns.2017.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 12/03/2016] [Accepted: 01/02/2017] [Indexed: 02/05/2023]
Abstract
The goals of the study were to analyze spontaneous neural activity between deficit and non-deficit schizophrenia (DS, NDS) using resting-state fMRI, and to investigate the correlation of fMRI with clinical features and evoked brain potentials. The amplitude of low frequency fluctuation (ALFF) was measured in 41 DS participants, 42 NDS participants, and 42 healthy controls. ALFF in the bilateral cerebellum posterior lobe was significantly decreased in patients, while ALFF in the right fusiform gyrus and the bilateral putamen was significantly increased. In schizophrenia patients, ALFF in the right putamen positively correlated with excited/activation on Positive and Negative Syndrome Scale (PANSS-EXC/ACT). In DS patients, ALFF in the right insula was significantly increased than in controls and positively correlated with S2-P50 amplitude of sensory gating P50. ALFF in the left cerebellum posterior lobe negatively correlated with negative symptoms and withdrawn on PANSS (PANSS-NS, PANSS-WIT), ALFF in the right putamen positively correlated with PANSS-WIT. In NDS patients, ALFF in the middle temporal gyrus decreased than in controls and negatively correlated with P3b subcomponent of P300 latency. ALFF in the left cerebellum posterior lobe negatively correlated with PANSS-EXC/ACT. The middle temporal gyrus in NDS or the right insula in DS may show spatiotemporal defects.
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Affiliation(s)
- Zhe Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Lei
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; The Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Wei Deng
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhong Zheng
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; The Neurobiological Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Mingli Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaohong Ma
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiang Wang
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chaohua Huang
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; The Psychiatry Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Na Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - David A Collier
- Discovery Neuroscience Research, Eli Lilly and Company Ltd., Lilly Research Laboratories, Erl Wood Manor, Windlesham, Surrey, United Kingdom
| | - Qiyong Gong
- MRI Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tao Li
- The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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Szendi I, Szabó N, Domján N, Kincses ZT, Palkó A, Vécsei L, Racsmány M. A New Division of Schizophrenia Revealed Expanded Bilateral Brain Structural Abnormalities of the Association Cortices. Front Psychiatry 2017; 8:127. [PMID: 28775696 PMCID: PMC5517392 DOI: 10.3389/fpsyt.2017.00127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 06/30/2017] [Indexed: 11/18/2022] Open
Abstract
The phenomenological and, consequently, pathophysiological heterogeneity of schizophrenia may be substantially decreased by determining etiologically valid subgroups. In a cross-sectional study, we analyzed the brain structural impairments of outpatients with schizophrenia using concurrent subgrouping methods, partly to enhance the extensity of exploration, and partly to estimate the validation of the divisions. High resolution T1-weighted MR images were obtained for 21 patients and 13 healthy controls. Localized gray matter volumetric deficits were defined with optimized voxel-based morphometry. Employing two concurrent methods (i.e., the widely known deficit-non-deficit division vs. the neurocognitive clusters we identified earlier) the patient group was iteratively divided into two subgroups, and their volumetric peculiarities were compared with one another and with healthy controls. Our division revealed more significant differences demonstrating bilateral brain structural deficits, which affected the association cortices, primarily the heteromodal fields and partly the unimodal fields. This is the first study that showed that abnormalities of the association cortices can be bihemispherial and expanded in schizophrenia, even in the cases of outpatients living integrated in society. Our result suggests that the extended association cortex abnormalities could constitute substantial and determining neurological substrates in the phenomenology and aetiopathogenesis of schizophrenia, at least in a subgroup of patients with more unfavorable neurocognitive characteristics.
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Affiliation(s)
- István Szendi
- Department of Psychiatry, University of Szeged, Szeged, Hungary
| | - Nikoletta Szabó
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Nóra Domján
- Department of Psychiatry, University of Szeged, Szeged, Hungary
| | | | - András Palkó
- Department of Radiology, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary.,Neuroscience Research Group, Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - Mihály Racsmány
- Research Group on Frontostriatal Disorders, Hungarian Academy of Sciences, Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary
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De Rossi P, Dacquino C, Piras F, Caltagirone C, Spalletta G. Left nucleus accumbens atrophy in deficit schizophrenia: A preliminary study. Psychiatry Res Neuroimaging 2016; 254:48-55. [PMID: 27322868 DOI: 10.1016/j.pscychresns.2016.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 06/02/2016] [Accepted: 06/04/2016] [Indexed: 01/21/2023]
Abstract
A question that remains to be answered is whether schizophrenia can be characterized by a single etiopathophysiology or whether separate sub-syndromes should be differentiated to define specific mechanisms for each sub-type. Individuals affected by the deficit subtype of schizophrenia (DSZ) display avolitional/amotivational features that respond poorly to conventional treatments. Characterizing DSZ from a neuroanatomical point of view may help clarify this issue and develop new treatment strategies. To determine if DSZ is associated with structural alterations in specific deep grey matter structures linked to its key clinical features, 22 DSZ patients, 22 non-deficit schizophrenia (NDSZ) patients and 22 healthy controls (HC) were recruited for a case-control cross-sectional study. High-resolution magnetic resonance imaging was performed in all subjects and volumes of deep grey matter structures were measured using FreeSurfer. DSZ patients displayed smaller left accumbens volumes compared to both NDSZ patients and HC. Moreover, age and duration of illness were significantly associated with lower volume of the left accumbens in DSZ but not in NDSZ. Findings indicate that DSZ is associated with lower volume of the nucleus accumbens in the dominant hemisphere. This is consistent with the psychopathological features and functional impairments present in DSZ and thus indicates a potential mechanism.
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Affiliation(s)
- Pietro De Rossi
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department NESMOS, Faculty of Medicine and Psychology, University "Sapienza" of Rome, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
| | - Claudia Dacquino
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Fabrizio Piras
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Department of Neuroscience, "Tor Vergata" University, 00173, Rome, Italy
| | - Gianfranco Spalletta
- Department of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, 00179, Rome, Italy; Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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McKechanie AG, Moorhead TWJ, Stanfield AC, Whalley HC, Johnstone EC, Lawrie SM, Owens DGC. Negative symptoms and longitudinal grey matter tissue loss in adolescents at risk of psychosis: preliminary findings from a 6-year follow-up study. Br J Psychiatry 2016; 208:565-70. [PMID: 26635326 DOI: 10.1192/bjp.bp.114.154526] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 11/20/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Negative symptoms are perhaps the most disabling feature of schizophrenia. Their pathogenesis remains poorly understood and it has been difficult to assess their development over time with imaging techniques. AIMS To examine, using tensor-based structural imaging techniques, whether there are regions of progressive grey matter volume change associated with the development of negative symptoms. METHOD A total of 43 adolescents at risk of psychosis were examined using magnetic resonance imaging and whole brain tensor-based morphometry at two time points, 6 years apart. RESULTS When comparing the individuals with significant negative symptoms with the remaining participants, we identified five regions of significant grey matter tissue loss over the 6-year period. These regions included the left temporal lobe, the left cerebellum, the left posterior cingulate and the left inferior parietal sulcus. CONCLUSIONS Negative symptoms are associated with longitudinal grey matter tissue loss. The regions identified include areas associated with psychotic symptoms more generally but also include regions uniquely associated with negative symptoms.
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Affiliation(s)
- Andrew G McKechanie
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Thomas W J Moorhead
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Andrew C Stanfield
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Heather C Whalley
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Eve C Johnstone
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Stephen M Lawrie
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - David G C Owens
- Andrew G. McKechanie, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Thomas W. J. Moorhead, PhD, Division of Psychiatry, The University of Edinburgh, Edinburgh; Andrew C. Stanfield, PhD, MRCPsych, The Patrick Wild Centre, The University of Edinburgh, Edinburgh; Heather C. Whalley, PhD, Eve C. Johnstone, MD, FRCP, FRCPsych, Stephen M. Lawrie, MD, FRCPE, FRCPsych, David G. C. Owens, MD, FRCP, FRCPsych, Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
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Lei W, Deng W, Li M, He Z, Han Y, Huang C, Ma X, Wang Q, Guo W, Li Y, Jiang L, Gong Q, Hu X, Zhang N, Li T. Gray matter volume alterations in first-episode drug-naïve patients with deficit and nondeficit schizophrenia. Psychiatry Res 2015; 234:219-226. [PMID: 26409573 PMCID: PMC4859347 DOI: 10.1016/j.pscychresns.2015.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 06/16/2015] [Accepted: 09/02/2015] [Indexed: 02/05/2023]
Abstract
Different patterns of gray matter volume (GMV) abnormalities have been reported between chronic patients with deficit schizophrenia (DS), relative to nondeficit schizophrenia (NDS) patients. However, it is not clear whether these differences are characteristic to the pathophysiology of DS or due to the effects of medications or illness durations. To address this issue, GMV in 88 first-episode, drug-naive patients with schizophrenia (44 DS and 44 NDS), 67 of their first-degree relatives and 84 healthy controls were assessed using voxel- based morphometry (VBM) and compared between groups. Correlations between GMV and clinical symptoms in patients were also assessed. Compared to controls, DS patients displayed more severe GMV reduction in the cerebellar culmen than NDS patients. GMV reduction in culmen was also observed in the first-degree relatives of DS (but not NDS) patients, suggesting possible different genetic risk in DS and NDS. The left insula was significantly smaller in DS patients than both NDS patients and controls, and smaller GMV of this region was associated with more severe negative symptoms in patients. Our results collectively indicate that DS might represent a distinct subtype of schizophrenia from NDS and the GMV change in left insula may be a morphological signature of DS.
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Affiliation(s)
- Wei Lei
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Wei Deng
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Mingli Li
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Zongling He
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Yuanyuan Han
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Chaohua Huang
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Xiaohong Ma
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Qiang Wang
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Wanjun Guo
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Yinfei Li
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Lijun Jiang
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Qiyong Gong
- Huaxi MRI center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China
| | - Xun Hu
- Department of Clinical Neuroscience, King's College London, Medical Research Council (MRC) Centre for Neurodegeneration Research, Institute of Psychiatry, London, UK
| | - Nanyin Zhang
- Department of Biomedical Engineering, The Huck Institutes of the Life Sciences,The Pennsylvania State University, W-341 Millennium Science Complex, University Park, PA 16802, USA, Correspondence Authors: Tao Li. No. 28 South Dianxin Street, Wuhou District, Chengdu, Sichuan Province, 610041, P. R. China. Phone: 86-028-85423561/Fax: 00-86-2885422632. , Nanyin Zhang. W-341 Millenium Science Complex, University Park, PA 16802, USA. Phone: 814-867-4791.
| | - Tao Li
- The Mental Health Center & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China, Correspondence Authors: Tao Li. No. 28 South Dianxin Street, Wuhou District, Chengdu, Sichuan Province, 610041, P. R. China. Phone: 86-028-85423561/Fax: 00-86-2885422632. , Nanyin Zhang. W-341 Millenium Science Complex, University Park, PA 16802, USA. Phone: 814-867-4791.
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Galderisi S, Merlotti E, Mucci A. Neurobiological background of negative symptoms. Eur Arch Psychiatry Clin Neurosci 2015; 265:543-58. [PMID: 25797499 DOI: 10.1007/s00406-015-0590-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 03/15/2015] [Indexed: 01/29/2023]
Abstract
Studies investigating neurobiological bases of negative symptoms of schizophrenia failed to provide consistent findings, possibly due to the heterogeneity of this psychopathological construct. We tried to review the findings published to date investigating neurobiological abnormalities after reducing the heterogeneity of the negative symptoms construct. The literature in electronic databases as well as citations and major articles are reviewed with respect to the phenomenology, pathology, genetics and neurobiology of schizophrenia. We searched PubMed with the keywords "negative symptoms," "deficit schizophrenia," "persistent negative symptoms," "neurotransmissions," "neuroimaging" and "genetic." Additional articles were identified by manually checking the reference lists of the relevant publications. Publications in English were considered, and unpublished studies, conference abstracts and poster presentations were not included. Structural and functional imaging studies addressed the issue of neurobiological background of negative symptoms from several perspectives (considering them as a unitary construct, focusing on primary and/or persistent negative symptoms and, more recently, clustering them into factors), but produced discrepant findings. The examined studies provided evidence suggesting that even primary and persistent negative symptoms include different psychopathological constructs, probably reflecting the dysfunction of different neurobiological substrates. Furthermore, they suggest that complex alterations in multiple neurotransmitter systems and genetic variants might influence the expression of negative symptoms in schizophrenia. On the whole, the reviewed findings, representing the distillation of a large body of disparate data, suggest that further deconstruction of negative symptomatology into more elementary components is needed to gain insight into underlying neurobiological mechanisms.
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Affiliation(s)
- Silvana Galderisi
- Department of Psychiatry, Second University of Naples (SUN), L.go Madonna delle Grazie, 1, 80138, Naples, Italy.
| | - Eleonora Merlotti
- Department of Psychiatry, Second University of Naples (SUN), L.go Madonna delle Grazie, 1, 80138, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, Second University of Naples (SUN), L.go Madonna delle Grazie, 1, 80138, Naples, Italy
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Yu M, Tang X, Wang X, Zhang X, Zhang X, Sha W, Yao S, Shu N, Zhang X, Zhang Z. Neurocognitive Impairments in Deficit and Non-Deficit Schizophrenia and Their Relationships with Symptom Dimensions and Other Clinical Variables. PLoS One 2015; 10:e0138357. [PMID: 26381645 PMCID: PMC4575183 DOI: 10.1371/journal.pone.0138357] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 08/28/2015] [Indexed: 11/18/2022] Open
Abstract
Background Deficit schizophrenia (DS) has been proposed as a pathophysiologically distinct subgroup within schizophrenia. Earlier studies focusing on neurocognitive function of DS patients have yielded inconsistent findings ranging from substantial deficits to no significant difference relative to non-deficit schizophrenia patients (NDS). The present study investigated the severity and characteristic patterns of neurocognitive impairments in DS and NDS patients and their relationships with clinical variables. Methods Attention, ideation fluency, cognitive flexibility and visuospatial memory function were assessed in 40 DS patients, 57 NDS patients, and 52 healthy controls by a comprehensive neuropsychological battery. Results Both schizophrenia subgroups had overall more severe cognitive impairments than controls while DS performed worse on every neuropsychological measure except the Stroop interference than the NDS patients with age and education as the covariates. Profile analysis found significantly different patterns of cognitive profiles between two patients group mainly due to their differences in attention and cognitive flexibility functions. Age, education, illness duration and negative symptoms were found to have the correlations with cognitive impairments in the NDS group, while only age and the negative symptoms were correlated with the cognitive impairments in the DS group. Multiple regression analyses revealed that sustained attention and cognitive flexibility were the core impaired cognitive domains mediating other cognitive functions in DS and NDS patients respectively. Conclusions DS patients exemplified worse in almost all cognitive domains than NDS patients. Sustained attention and cognitive flexibility might be the key impaired cognitive domains for DS and NDS patients respectively. The present study suggested the DS as a specific subgroup of schizophrenia.
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Affiliation(s)
- Miao Yu
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - XiaoWei Tang
- Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Xiang Wang
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - XiangRong Zhang
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
- Department of Geriatric Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
- * E-mail: (XRZ); (ZJZ)
| | - XiaoBin Zhang
- Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - WeiWei Sha
- Department of Psychiatry, Wutaishan Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - ShuQiao Yao
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - XiangYang Zhang
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, United States of America
| | - ZhiJun Zhang
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
- * E-mail: (XRZ); (ZJZ)
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Schizophrenia and bipolar disorder: The road from similarities and clinical heterogeneity to neurobiological types. Clin Chim Acta 2015; 449:49-59. [DOI: 10.1016/j.cca.2015.02.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 01/06/2023]
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Ahmed AO, Strauss GP, Buchanan RW, Kirkpatrick B, Carpenter WT. Are Negative Symptoms Dimensional or Categorical? Detection and Validation of Deficit Schizophrenia With Taxometric and Latent Variable Mixture Models. Schizophr Bull 2015; 41:879-91. [PMID: 25399026 PMCID: PMC4466177 DOI: 10.1093/schbul/sbu163] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Studies have supported the validity of the deficit form of schizophrenia (ie, people with primary and enduring negative symptoms). A test of whether that group is a true taxon-that is, a distinct, discontinuous group-has yet to be conducted and the underlying structure of negative symptoms as categorical or dimensional remains undetermined. The present study examined the latent structure of negative and deficit symptoms to determine if a nonarbitrary boundary distinguishes deficit from nondeficit forms of schizophrenia (ie, whether these symptoms reflect a continuous or categorical variable). Schedule for the Deficit Syndrome ratings of 789 individuals with a psychotic disorder were submitted to taxometric and latent variable mixture analyses to test categorical vs dimensional hypotheses of negative symptoms and deficit schizophrenia. Analytic models favored a taxonic structure of negative symptoms and the validity of the deficit/nondeficit classification scheme. Taxometric classification outperformed clinician-based deficit/nondeficit classification in its association with summer birth, male sex, premorbid adjustment, neurocognition, and psychosocial functioning. Within taxon and complement classes, severity scores remained significant predictors of premorbid adjustment, neurocognition, and psychosocial functioning. Thus, although a categorical approach is validated, a hybrid categorical-dimensional conceptualization of negative symptoms also has validity for the prediction of external variables.
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Affiliation(s)
- Anthony O. Ahmed
- Department of Psychiatry, Weill Cornell Medical College, White Plains, NY;,Department of Psychiatry and Health Behavior, Medical College of Georgia, Georgia Regents University, Augusta, GA;,*To whom correspondence should be addressed; Department of Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10605, US; tel: 914-997-5251, fax: 914-682-6906, e-mail:
| | | | - Robert W. Buchanan
- Department of Psychiatry;,Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - Brian Kirkpatrick
- Department of Psychiatry, University of Nevada School of Medicine, Reno, NV
| | - William T. Carpenter
- Department of Psychiatry;,Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
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21
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Mucci A, Dima D, Soricelli A, Volpe U, Bucci P, Frangou S, Prinster A, Salvatore M, Galderisi S, Maj M. Is avolition in schizophrenia associated with a deficit of dorsal caudate activity? A functional magnetic resonance imaging study during reward anticipation and feedback. Psychol Med 2015; 45:1765-1778. [PMID: 25577954 PMCID: PMC4416282 DOI: 10.1017/s0033291714002943] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 10/17/2014] [Accepted: 11/19/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND The neurobiological underpinnings of avolition in schizophrenia remain unclear. Most brain imaging research has focused on reward prediction deficit and on ventral striatum dysfunction, but findings are not consistent. In the light of accumulating evidence that both ventral striatum and dorsal caudate play a key role in motivation, we investigated ventral striatum and dorsal caudate activation during processing of reward or loss in patients with schizophrenia. METHOD We used functional magnetic resonance imaging to study brain activation during a Monetary Incentive Delay task in patients with schizophrenia, treated with second-generation antipsychotics only, and in healthy controls (HC). We also assessed the relationships of ventral striatum and dorsal caudate activation with measures of hedonic experience and motivation. RESULTS The whole patient group had lower motivation but comparable hedonic experience and striatal activation than HC. Patients with high avolition scores showed lower dorsal caudate activation than both HC and patients with low avolition scores. A lower dorsal caudate activation was also observed in patients with deficit schizophrenia compared to HC and patients with non-deficit schizophrenia. Dorsal caudate activity during reward anticipation was significantly associated with avolition, but not with anhedonia in the patient group. CONCLUSIONS These findings suggest that avolition in schizophrenia is linked to dorsal caudate hypoactivation.
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Affiliation(s)
- A. Mucci
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - D. Dima
- Psychosis Research Program, Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew York, USA
- MRC Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's CollegeLondon, UK
| | - A. Soricelli
- University of Naples ‘Parthenope’ and IRCCS Research Institute SDN, Naples, Italy
| | - U. Volpe
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - P. Bucci
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - S. Frangou
- Psychosis Research Program, Department of Psychiatry, Icahn School of Medicine at Mount SinaiNew York, USA
| | - A. Prinster
- Biostructure and Bioimaging Institute, National Research Council, Naples, Italy
| | - M. Salvatore
- Department of Biomorphological and Functional Studies, University of Naples ‘Federico II’, Naples, Italy
| | - S. Galderisi
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - M. Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
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Shin JE, Choi SH, Lee H, Shin YS, Jang DP, Kim JJ. Involvement of the dorsolateral prefrontal cortex and superior temporal sulcus in impaired social perception in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2015; 58:81-8. [PMID: 25545410 DOI: 10.1016/j.pnpbp.2014.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/05/2014] [Accepted: 12/19/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND Schizophrenia is a mental disorder characterized by impairments in diverse thinking and emotional responses, which are related to social perception dysfunction. This fMRI study was designed to investigate a neurobiological basis of social perception deficits of patients with schizophrenia in various social situations of daily life and their relationship with clinical symptoms and social dysfunction. METHODS Seventeen patients and 19 controls underwent functional magnetic resonance imaging, during which participants performed a virtual social perception task, containing an avatar's speech with positive, negative or neutral emotion in a virtual reality space. Participants were asked to determine whether or not the avatar's speech was appropriate to each situation. RESULTS The significant group×appropriateness interaction was seen in the left dorsolateral prefrontal cortex (DLPFC), resulting from lower activity in patients in the inappropriate condition, and left DLPFC activity was negatively correlated with the severity of negative symptoms and positively correlated with the level of social functioning. The significant appropriateness×emotion interaction observed in the left superior temporal sulcus (STS) was present in controls, but absent in patients, resulting from the existence and absence of a difference between the inappropriate positive and negative conditions, respectively. CONCLUSIONS These findings indicate that dysfunction of the DLPFC-STS network may underlie patients' abnormal social perception in various social situations of daily life. Abnormal functioning of this network may contribute to increases of negative symptoms and decreases of social functioning.
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Affiliation(s)
- Jung Eun Shin
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Hyeongrae Lee
- Magnetoencephalography center, Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Seok Shin
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Dong-Pyo Jang
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Jae-Jin Kim
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Padmanabhan JL, Tandon N, Haller CS, Mathew IT, Eack SM, Clementz BA, Pearlson GD, Sweeney JA, Tamminga CA, Keshavan MS. Correlations between brain structure and symptom dimensions of psychosis in schizophrenia, schizoaffective, and psychotic bipolar I disorders. Schizophr Bull 2015; 41:154-162. [PMID: 24907239 PMCID: PMC4266291 DOI: 10.1093/schbul/sbu075] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Structural alterations may correlate with symptom severity in psychotic disorders, but the existing literature on this issue is heterogeneous. In addition, it is not known how cortical thickness and cortical surface area correlate with symptom dimensions of psychosis. METHODS Subjects included 455 individuals with schizophrenia, schizoaffective, or bipolar I disorders. Data were obtained as part of the Bipolar Schizophrenia Network for Intermediate Phenotypes study. Diagnosis was made through the Structured Clinical Interview for DSM-IV. Positive and negative symptom subscales were assessed using the Positive and Negative Syndrome Scale. Structural brain measurements were extracted from T1-weight structural MRIs using FreeSurfer v5.1 and were correlated with symptom subscales using partial correlations. Exploratory factor analysis was also used to identify factors among those regions correlating with symptom subscales. RESULTS The positive symptom subscale correlated inversely with gray matter volume (GMV) and cortical thickness in frontal and temporal regions, whereas the negative symptom subscale correlated inversely with right frontal cortical surface area. Among regions correlating with the positive subscale, factor analysis identified four factors, including a temporal cortical thickness factor and frontal GMV factor. Among regions correlating with the negative subscale, factor analysis identified a frontal GMV-cortical surface area factor. There was no significant diagnosis by structure interactions with symptom severity. CONCLUSIONS Structural measures correlate with positive and negative symptom severity in psychotic disorders. Cortical thickness demonstrated more associations with psychopathology than cortical surface area.
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Affiliation(s)
- Jaya L Padmanabhan
- Department of Psychiatry, Beth Israel Deaconess Medical Center , Boston, MA; Division of Public Psychiatry, Massachusetts Mental Health Center , Boston, MA
| | - Neeraj Tandon
- Department of Psychiatry, Beth Israel Deaconess Medical Center , Boston, MA; Division of Public Psychiatry, Massachusetts Mental Health Center , Boston, MA
| | | | - Ian T Mathew
- Department of Psychiatry, Beth Israel Deaconess Medical Center , Boston, MA; Division of Public Psychiatry, Massachusetts Mental Health Center , Boston, MA
| | - Shaun M Eack
- School of Social Work, Psychiatry, and Clinical and Translational Sciences Institute, University of Pittsburgh, Pittsburgh, PA; Western Psychiatric Institute and Clinic, Pittsburgh, PA
| | - Brett A Clementz
- Departments of Psychiatry and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University, New Haven, CT; Olin Neuropsychiatry Research Center, Hartford Hospital/Institute of Living, Hartford, CT
| | - John A Sweeney
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center , Boston, MA; Division of Public Psychiatry, Massachusetts Mental Health Center , Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA;
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24
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Millan MJ, Fone K, Steckler T, Horan WP. Negative symptoms of schizophrenia: clinical characteristics, pathophysiological substrates, experimental models and prospects for improved treatment. Eur Neuropsychopharmacol 2014; 24:645-92. [PMID: 24820238 DOI: 10.1016/j.euroneuro.2014.03.008] [Citation(s) in RCA: 243] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 03/19/2014] [Indexed: 12/11/2022]
Abstract
Schizophrenia is a complex and multifactorial disorder generally diagnosed in young adults at the time of the first psychotic episode of delusions and hallucinations. These positive symptoms can be controlled in most patients by currently-available antipsychotics. Conversely, they are poorly effective against concomitant neurocognitive dysfunction, deficits in social cognition and negative symptoms (NS), which strongly contribute to poor functional outcome. The precise notion of NS has evolved over the past century, with recent studies - underpinned by novel rating methods - suggesting two major sub-domains: "decreased emotional expression", incorporating blunted affect and poverty of speech, and "avolition", which embraces amotivation, asociality and "anhedonia" (inability to anticipate pleasure). Recent studies implicate a dysfunction of frontocortico-temporal networks in the aetiology of NS, together with a disruption of cortico-striatal circuits, though other structures are also involved, like the insular and parietal cortices, amygdala and thalamus. At the cellular level, a disruption of GABAergic-glutamatergic balance, dopaminergic signalling and, possibly, oxytocinergic and cannibinoidergic transmission may be involved. Several agents are currently under clinical investigation for the potentially improved control of NS, including oxytocin itself, N-Methyl-d-Aspartate receptor modulators and minocycline. Further, magnetic-electrical "stimulation" strategies to recruit cortical circuits and "cognitive-behavioural-psychosocial" therapies likewise hold promise. To acquire novel insights into the causes and treatment of NS, experimental study is crucial, and opportunities are emerging for improved genetic, pharmacological and developmental modelling, together with more refined readouts related to deficits in reward, sociality and "expression". The present article comprises an integrative overview of the above issues as a platform for this Special Issue of European Neuropsychopharmacology in which five clinical and five preclinical articles treat individual themes in greater detail. This Volume provides, then, a framework for progress in the understanding - and ultimately control - of the debilitating NS of schizophrenia.
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Affiliation(s)
- Mark J Millan
- Pole of Innovation in Neuropsychiatry, Institut de Recherche Servier, 125 Chemin de Ronde, 78290 Croissy-sur-Seine, Paris, France.
| | - Kevin Fone
- School of Biomedical Sciences, Medical School, Queen׳s Medical Centre, Nottingham University, Nottingham NG72UH, UK
| | - Thomas Steckler
- Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium
| | - William P Horan
- VA Greater Los Angeles Healthcare System, University of California, Los Angeles, MIRECC 210A, Bldg. 210, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA
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Hirjak D, Breyer T, Thomann PA, Fuchs T. Disturbance of intentionality: a phenomenological study of body-affecting first-rank symptoms in schizophrenia. PLoS One 2013; 8:e73662. [PMID: 24019932 PMCID: PMC3760919 DOI: 10.1371/journal.pone.0073662] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 07/19/2013] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES In 1950, Kurt Schneider proposed that a considerable number of schizophrenia patients develop first-rank symptoms (FRS). In such cases, patients report made experiences, replaced control of will, thought insertion, broadcast or withdrawal and delusional perception, respectively. Although a number of recent studies tend to explain FRS in terms of neurobiological and neuropsychological processes, the origin of these symptoms still remains unknown. In this paper, we explore the subjective experience of patients with the following two FRS: (1) "made" impulses and (2) "made" volitional acts. METHOD The method applied for the study of two FRS consists first in the overview of psychiatric and philosophical literature and second in the further investigation of subjective experience in patients with FRS. Psychopathological and phenomenological aspects of FRS are discussed by means of patient cases. RESULTS We discovered a profound transformation of intentionality and agency in schizophrenia patients with body-affecting FRS. This concept offers an insight into the interrelatedness between particular FRS. CONCLUSION We propose that the subjective experience of schizophrenia patients with body-affecting FRS is rooted in the disturbance of intentionality and diminished sense of agency. This theoretical account of body-affecting FRS will open up new directions in both phenomenological and neurobiological psychiatric research.
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Affiliation(s)
- Dusan Hirjak
- Section Phenomenological Psychopathology and Psychotherapy, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- Structural Neuroimaging Group, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Thiemo Breyer
- Section Phenomenological Psychopathology and Psychotherapy, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Philipp Arthur Thomann
- Structural Neuroimaging Group, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Thomas Fuchs
- Section Phenomenological Psychopathology and Psychotherapy, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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Ahmed AO, Buckley PF, Hanna M. Neuroimaging schizophrenia: a picture is worth a thousand words, but is it saying anything important? Curr Psychiatry Rep 2013; 15:345. [PMID: 23397252 DOI: 10.1007/s11920-012-0345-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Schizophrenia is characterized by neurostructural and neurofunctional aberrations that have now been demonstrated through neuroimaging research. The article reviews recent studies that have attempted to use neuroimaging to understand the relation between neurological abnormalities and aspects of the phenomenology of schizophrenia. Neuroimaging studies show that neurostructural and neurofunctional abnormalities are present in people with schizophrenia and their close relatives and may represent putative endophenotypes. Neuroimaging phenotypes predict the emergence of psychosis in individuals classified as high-risk. Neuroimaging studies have linked structural and functional abnormalities to symptoms; and progressive structural changes to clinical course and functional outcome. Neuroimaging has successfully indexed the neurotoxic and neuroprotective effects of schizophrenia treatments. Pictures can inform about aspects of the phenomenology of schizophrenia including etiology, onset, symptoms, clinical course, and treatment effects but this assertion is tempered by the scientific and practical limitations of neuroimaging.
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Affiliation(s)
- Anthony O Ahmed
- Department of Psychiatry and Health Behavior, Georgia Health Sciences University, 997 Saint Sebastian Way, Augusta, GA 30912, USA.
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Lakhan SE. Mass spectrometric analysis of prefrontal cortex proteins in schizophrenia and bipolar disorder. SPRINGERPLUS 2012; 1:3. [PMID: 23984221 PMCID: PMC3581108 DOI: 10.1186/2193-1801-1-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 04/11/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are the two most serious and debilitating neuropsychiatric disorders that share many characteristics, both symptomatic and epidemiological. There has yet to be a single diagnostic biomarker discovered for schizophrenia and bipolar disorder. Proteomics holds promise in elucidating the pathophysiology of these neuropsychiatric disorders from each other and healthy individuals. FINDINGS Postmortem prefrontal cortex tissue from schizophrenia, bipolar disorder, and psychiatric-free controls (n = 35 in each group) were subject to SELDI-TOF-MS protein profiling. There were 13 protein peaks distinguishing schizophrenia versus control and 15 in bipolar versus control. Using a predictor set of 10 peaks for each comparison, 73% prediction accuracy (p = 2.3×10(-4)) was achieved. Three peaks were in common between schizophrenia and bipolar disorder. CONCLUSIONS This pilot study found protein profiles that distinguished schizophrenia and bipolar patients from controls and notably from each other. Identifying and characterizing the proteins in this study may elucidate neuropsychiatric phenotypes and uncover therapeutic targets. Further, applying class prediction bioinformatics may allow the clinician to differentiate the two phenotypes by profiling CSF or even serum.
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