1
|
Williams JC, Zheng ZJ, Tubiolo PN, Luceno JR, Gil RB, Girgis RR, Slifstein M, Abi-Dargham A, Van Snellenberg JX. Medial Prefrontal Cortex Dysfunction Mediates Working Memory Deficits in Patients With Schizophrenia. Biol Psychiatry Glob Open Sci 2023; 3:990-1002. [PMID: 37881571 PMCID: PMC10593895 DOI: 10.1016/j.bpsgos.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 02/18/2023] Open
Abstract
Background Schizophrenia (SCZ) is marked by working memory (WM) deficits, which predict poor functional outcome. While most functional magnetic resonance imaging studies of WM in SCZ have focused on the dorsolateral prefrontal cortex (PFC), some recent work suggests that the medial PFC (mPFC) may play a role. We investigated whether task-evoked mPFC deactivation is associated with WM performance and whether it mediates deficits in SCZ. In addition, we investigated associations between mPFC deactivation and cortical dopamine release. Methods Patients with SCZ (n = 41) and healthy control participants (HCs) (n = 40) performed a visual object n-back task during functional magnetic resonance imaging. Dopamine release capacity in mPFC was quantified with [11C]FLB457 in a subset of participants (9 SCZ, 14 HCs) using an amphetamine challenge. Correlations between task-evoked deactivation and performance were assessed in mPFC and dorsolateral PFC masks and were further examined for relationships with diagnosis and dopamine release. Results mPFC deactivation was associated with WM task performance, but dorsolateral PFC activation was not. Deactivation in the mPFC was reduced in patients with SCZ relative to HCs and mediated the relationship between diagnosis and WM performance. In addition, mPFC deactivation was significantly and inversely associated with dopamine release capacity across groups and in HCs alone, but not in patients. Conclusions Reduced WM task-evoked mPFC deactivation is a mediator of, and potential substrate for, WM impairment in SCZ, although our study design does not rule out the possibility that these findings could relate to cognition in general rather than WM specifically. We further present preliminary evidence of an inverse association between deactivation during WM tasks and dopamine release capacity in the mPFC.
Collapse
Affiliation(s)
- John C. Williams
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Zu Jie Zheng
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Philip N. Tubiolo
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
| | - Jacob R. Luceno
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Roberto B. Gil
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Presbyterian/Columbia University Irving Medical Center, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - Ragy R. Girgis
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Presbyterian/Columbia University Irving Medical Center, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - Mark Slifstein
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Presbyterian/Columbia University Irving Medical Center, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - Anissa Abi-Dargham
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Presbyterian/Columbia University Irving Medical Center, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - Jared X. Van Snellenberg
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Presbyterian/Columbia University Irving Medical Center, New York, New York
- New York State Psychiatric Institute, New York, New York
- Department of Psychology, Stony Brook University, Stony Brook, New York
| |
Collapse
|
2
|
Wang F, Xi C, Liu Z, Deng M, Zhang W, Cao H, Yang J, Palaniyappan L. Load-dependent inverted U-shaped connectivity of the default mode network in schizophrenia during a working-memory task: evidence from a replication functional MRI study. J Psychiatry Neurosci 2022; 47:E341-E350. [PMID: 36167413 PMCID: PMC9524478 DOI: 10.1503/jpn.220053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/28/2022] [Accepted: 08/05/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Working-memory deficit is associated with aberrant degree distribution of the brain connectome in schizophrenia. However, the brain neural mechanism underlying the degree redistribution pattern in schizophrenia is still uncertain. METHODS We examined the functional degree distribution of the connectome in 81 patients with schizophrenia and 77 healthy controls across different working-memory loads during an n-back task. We tested the associations between altered degree distribution and clinical symptoms, and we conducted functional connectivity analyses to investigate the neural mechanism underlying altered degree distribution. We repeated these analyses in a second independent data set of 96 participants. In the second data set, we employed machine-learning analysis to study whether the degree distribution pattern of one data set could be used to discriminate between patients with schizophrenia and controls in the other data set. RESULTS Patients with schizophrenia showed decreased centrality in the dorsal posterior cingulate cortex (dPCC) for the "2-back versus 0-back" contrast compared to healthy controls. The dPCC centrality pattern across all working-memory loads was an inverted U shape, with a left shift of this pattern in patients with schizophrenia. This reduced centrality was correlated with the severity of delusions and related to reduced functional connectivity between the dPCC and the dorsal precuneus. We replicated these results with the second data set, and the machine-learning analyses achieved an accuracy level of 71%. LIMITATIONS We used a limited n-back paradigm that precluded the examination of higher working-memory loads. CONCLUSION Schizophrenia is characterized by a load-dependent reduction of centrality in the dPCC, related to the severity of delusions. We suggest that restoring dPCC centrality in the presence of cognitive demands might have a therapeutic effect on persistent delusions in people with schizophrenia.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Jie Yang
- From the Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, Hunan, China (Wang, Xi, Liu, Deng, Zhang, Yang); the National Clinical Research Centre for Mental Disorders, Changsha, Hunan, China (Wang, Xi, Liu, Deng, Zhang, Yang); the Centre for Psychiatric Neuroscience, Feinstein Institutes for Medical Research, Manhasset, New York (Cao); the Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (Cao); the Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Que. (Palaniyappan); the Department of Medical Biophysics, Western University, London, Ont. (Palaniyappan); the Robarts Research Institute, Western University, London, Ont. (Palaniyappan)
| | | |
Collapse
|
3
|
Abstract
Attention is clearly a core area of cognitive dysfunction in schizophrenia, but the concept of "attention" is complex and multifaceted. This chapter focuses on three different aspects of attentional function that are of particular interest in schizophrenia. First, we discuss the evidence that schizophrenia involves a reduction in global alertness, leading to an inward focusing of attention and a neglect of external stimuli and tasks. Second, we discuss the control of attention, the set of processes that allow general goals to be translated into shifts of attention toward task-relevant information. When a goal is adequately represented, people with schizophrenia often show no deficit in using the goal to direct attention in the visual modality unless challenged by stimuli that strongly activate the magnocellular processing pathway. Finally, we discuss the implementation of selection, the processes that boost relevant information and suppress distractors once attention has been directed to a given source of information. Although early evidence indicated an impairment in selection, more recent evidence indicating that people with schizophrenia actually focus their attention more narrowly and more intensely that healthy individuals (hyperfocusing). However, this hyperfocused attention may be directed toward goal-irrelevant information, creating the appearance of impaired attentional filtering.
Collapse
Affiliation(s)
- Steven J Luck
- Department of Psychology, Center for Mind and Brain, University of California, Davis, CA, USA.
| | - James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| |
Collapse
|
4
|
Yakubov B, Das S, Zomorrodi R, Blumberger DM, Enticott PG, Kirkovski M, Rajji TK, Desarkar P. Cross-frequency coupling in psychiatric disorders: A systematic review. Neurosci Biobehav Rev 2022; 138:104690. [PMID: 35569580 DOI: 10.1016/j.neubiorev.2022.104690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 05/02/2022] [Accepted: 05/08/2022] [Indexed: 11/21/2022]
Abstract
Cross-frequency coupling (CFC), an electrophysiologically derived measure of oscillatory coupling in the brain, is believed to play a critical role in neuronal computation, learning and communication. It has received much recent attention in the study of both health and disease. We searched for literature that studied CFC during resting state and task-related activities during electroencephalography and magnetoencephalography in psychiatric disorders. Thirty-eight studies were identified, which included attention-deficit hyperactivity disorder, Alzheimer's dementia, autism spectrum disorder, bipolar disorder, depression, obsessive compulsive disorder, social anxiety disorder and schizophrenia. The systematic review was registered with PROSPERO (ID#CRD42021224188). The current review indicates measurable differences exist between CFC in disease states vs. healthy controls. There was variance in CFC at different regions of the brain within the same psychiatric disorders, perhaps this could be explained by the mechanisms and functionality of CFC. There was heterogeneity in methodologies used, which may lead to spurious CFC analyses. Going forward, standardized methodologies need to be established and utilized in further research to understand the neuropathophysiology associated with psychiatric disorders.
Collapse
|
5
|
Abstract
Schizophrenia, characterised by psychotic symptoms and in many cases social and occupational decline, remains an aetiological and therapeutic challenge. Contrary to popular belief, the disorder is modestly more common in men than in women. Nor is the outcome uniformly poor. A division of symptoms into positive, negative, and disorganisation syndromes is supported by factor analysis. Catatonic symptoms are not specific to schizophrenia and so-called first rank symptoms are no longer considered diagnostically important. Cognitive impairment is now recognised as a further clinical feature of the disorder. Lateral ventricular enlargement and brain volume reductions of around 2% are established findings. Brain functional changes occur in different subregions of the frontal cortex and might ultimately be understandable in terms of disturbed interaction among large-scale brain networks. Neurochemical disturbance, involving dopamine function and glutamatergic N-methyl-D-aspartate receptor function, is supported by indirect and direct evidence. The genetic contribution to schizophrenia is now recognised to be largely polygenic. Birth and early life factors also have an important aetiological role. The mainstay of treatment remains dopamine receptor-blocking drugs; a psychological intervention, cognitive behavioural therapy, has relatively small effects on symptoms. The idea that schizophrenia is better regarded as the extreme end of a continuum of psychotic symptoms is currently influential. Other areas of debate include cannabis and childhood adversity as causative factors, whether there is progressive brain change after onset, and the long-term success of early intervention initiatives.
Collapse
Affiliation(s)
- Sameer Jauhar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - Mandy Johnstone
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK; National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Peter J McKenna
- FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
| |
Collapse
|
6
|
Alejandre-Lara AL, Canby NK, Wesbecher KD, Eichel K, Britton WB, Lindahl JR. How do Mindfulness-Based Programs Improve Depression Symptoms: Selflessness, Valence, or Valenced Self? Cogn Ther Res 2022. [DOI: 10.1007/s10608-021-10287-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
7
|
Erickson MA, Hahn B, Kiat JE, Alliende LM, Luck SJ, Gold JM. Neural basis of the visual working memory deficit in schizophrenia: Merging evidence from fMRI and EEG. Schizophr Res 2021; 236:61-68. [PMID: 34399233 PMCID: PMC8464530 DOI: 10.1016/j.schres.2021.07.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/13/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022]
Abstract
Although people with schizophrenia (PSZ) exhibit robust and reliable deficits in working memory (WM) capacity, the neural processes that give rise to this impairment remain poorly understood. One reason for this lack of clarity is that most studies employ a single neural recording modality-each with strengths and weaknesses-with few examples of integrating results across modalities. To address this gap, we conducted a secondary analysis that combined data from an overlapping set of subjects in previously published electroencephalographic and functional magnetic resonance imaging studies that used nearly identical working memory tasks (visual change detection). The prior studies found similar patterns of results for both posterior parietal BOLD activation and suppression of the alpha frequency band within the EEG. Specifically, both signals exhibited abnormally shallow modulation as a function of the amount of information being stored in WM in PSZ. In the present study, both alpha suppression and posterior parietal BOLD activity increased as the number of items stored in WM increased. The magnitude of alpha suppression modulation was correlated with the magnitude of BOLD signal modulation in PSZ, but not in HCS. This finding suggests that the same illness-related biological processes constrain both alpha suppression and BOLD signal modulation as a function of WM storage in PSZ. The complementary strengths of these two techniques may thus combine to advance the identification of the processes underlying WM deficits in PSZ.
Collapse
Affiliation(s)
- Molly A. Erickson
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60622,Corresponding author
| | - Britta Hahn
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - John E. Kiat
- Center for Mind & Brain and Department of Psychology, University of California, Davis
| | - Luz Maria Alliende
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60622
| | - Steven J. Luck
- Center for Mind & Brain and Department of Psychology, University of California, Davis
| | - James M. Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine
| |
Collapse
|
8
|
Wang X, Cheng B, Roberts N, Wang S, Luo Y, Tian F, Yue S. Shared and distinct brain fMRI response during performance of working memory tasks in adult patients with schizophrenia and major depressive disorder. Hum Brain Mapp 2021; 42:5458-5476. [PMID: 34431584 PMCID: PMC8519858 DOI: 10.1002/hbm.25618] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 02/05/2023] Open
Abstract
Working memory (WM) impairments are common features of psychiatric disorders. A systematic meta-analysis was performed to determine common and disorder-specific brain fMRI response during performance of WM tasks in patients with SZ and patients with MDD relative to healthy controls (HC). Thirty-four published fMRI studies of WM in patients with SZ and 18 published fMRI studies of WM in patients with MDD, including relevant HC, were included in the meta-analysis. In both SZ and MDD there was common stronger fMRI response in right medial prefrontal cortex (MPFC) and bilateral anterior cingulate cortex (ACC), which are part of the default mode network (DMN). The effects were of greater magnitude in SZ than MDD, especially in prefrontal-temporal-cingulate-striatal-cerebellar regions. In addition, a disorder-specific weaker fMRI response was observed in right middle frontal gyrus (MFG) in MDD, relative to HC. For both SZ and MDD a significant correlation was observed between the severity of clinical symptoms and lateralized fMRI response relative to HC. These findings indicate that there may be common and distinct anomalies in brain function underlying deficits in WM in SZ and MDD, which may serve as a potential functional neuroimaging-based diagnostic biomarker with value in supporting clinical diagnosis, measuring illness severity and assessing the efficacy of treatments for SZ and MDD at the brain level.
Collapse
Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Neil Roberts
- Edinburgh Imaging Facility, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ya Luo
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Suping Yue
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu, China
| |
Collapse
|
9
|
Martin-Subero M, Fuentes-Claramonte P, Salgado-Pineda P, Salavert J, Arevalo A, Bosque C, Sarri C, Guerrero-Pedraza A, Santo-Angles A, Capdevila A, Sarró S, Salvador R, McKenna PJ, Pomarol-Clotet E. Autobiographical memory and default mode network function in schizophrenia: an fMRI study. Psychol Med 2021; 51:121-128. [PMID: 31680659 PMCID: PMC7856411 DOI: 10.1017/s0033291719003052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND The brain functional correlates of autobiographical recall are well established, but have been little studied in schizophrenia. Additionally, autobiographical memory is one of a small number of cognitive tasks that activates rather than de-activates the default mode network, which has been found to be dysfunctional in this disorder. METHODS Twenty-seven schizophrenic patients and 30 healthy controls underwent functional magnetic resonance imaging while viewing cue words that evoked autobiographical memories. Control conditions included both non-memory-evoking cues and a low level baseline (cross fixation). RESULTS Compared to both non-memory evoking cues and low level baseline, autobiographical recall was associated with activation in default mode network regions in the controls including the medial frontal cortex, the posterior cingulate cortex and the hippocampus, as well as other areas. Clusters of de-activation were seen outside the default mode network. There were no activation differences between the schizophrenic patients and the controls, but the patients showed clusters of failure of de-activation in non-default mode network regions. CONCLUSIONS According to this study, patients with schizophrenia show intact activation of the default mode network and other regions associated with recall of autobiographical memories. The finding of failure of de-activation outside the network suggests that schizophrenia may be associated with a general difficulty in de-activation rather than dysfunction of the default mode network per se.
Collapse
Affiliation(s)
- Marta Martin-Subero
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Madrid, Spain
| | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Madrid, Spain
| | - Josep Salavert
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychiatry Department, Hospital Sant Rafael, Barcelona, Spain
| | - Antoni Arevalo
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Psychiatry Department, Hospital Sagrat Cor Martorell Barcelona, Barcelona, Spain
| | - Clara Bosque
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
| | - Carmen Sarri
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
| | - Amalia Guerrero-Pedraza
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Benito Menni Centre Assistencial en Salut Mental, Sant Boi de Llobregat, Barcelona, Spain
| | | | - Antoni Capdevila
- Radiology Unit, Hospital de la Santa Creu i Sant Pau (HSCSP), Barcelona, Spain
- CIBER-BBN (Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina), Zaragoza, Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Madrid, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Madrid, Spain
| | - Peter J. McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Madrid, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Madrid, Spain
| |
Collapse
|
10
|
Abstract
BACKGROUND Working memory (WM) deficits are seen as a core deficit in schizophrenia, implicated in the broad cognitive impairment seen in the illness. Here we examine the impact of WM storage of a single item on the operation of other cognitive systems. METHODS We studied 37 healthy controls (HCS) and 43 people with schizophrenia (PSZ). Each trial consisted of a sequence of two potential target stimuli, T1 and T2. T1 was a letter presented for 100 ms. After delays of 100-800 ms, T2 was presented. T2 was a 1 or a 2 and required a speeded response. In one condition, subjects were instructed to ignore T1 but respond to T2. In another condition, they were required to report T1 after making their speeded response to T2 (i.e. to make a speeded T2 response while holding T1 in WM). RESULTS PSZ were dramatically slowed at responding to T2 when T1 was held in WM. A repeated measures ANOVA yielded main effects of group, delay, and condition with a group by condition interaction (p's < 0.001). Across delays, the slowing of the T2 response when required to hold T1 in memory, relative to ignoring T1, was nearly 3 times higher in PSZ than HCS (633 v. 219 ms). CONCLUSIONS Whereas previous studies have focused on reduced storage capacity, the present study found that PSZ are impaired at performing tasks while they are successfully maintaining a single item in WM. This may play a role in the broad cognitive impairment seen in PSZ.
Collapse
Affiliation(s)
- James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - Sonia Bansal
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - John M Gaspar
- Center for Mind & Brain and Department of Psychology, University of California Davis, Davis, USA
| | - Shuo Chen
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - Benjamin M Robinson
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - Britta Hahn
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California Davis, Davis, USA
| |
Collapse
|
11
|
Lee TH, Kim M, Hwang WJ, Kim T, Kwak YB, Kwon JS. Relationship between resting-state theta phase-gamma amplitude coupling and neurocognitive functioning in patients with first-episode psychosis. Schizophr Res 2020; 216:154-60. [PMID: 31883931 DOI: 10.1016/j.schres.2019.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/28/2019] [Accepted: 12/17/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although cognitive dysfunction is a core element of schizophrenia, the neurobiological underpinnings of the pathophysiology are not yet sufficiently understood. Because the resting state is crucial for cognitive functioning and electroencephalography (EEG) can reflect instantaneous neural activity, we investigated theta phase-gamma amplitude coupling (TGC) of resting-state EEG and its relationship with cognitive function in patients with first-episode psychosis (FEP) to reveal the neural correlates of cognitive dysfunction. METHODS A total of 59 FEP patients and 50 healthy controls (HCs) underwent resting-state, eyes-closed EEG recordings and performed the Trail Making Test Part A (TMT-A) and Part B (TMT-B) and California Verbal Learning Test (CVLT). TGC from the source signal of the resting-state EEG in default mode network (DMN)-related brain regions was compared between groups. Correlation analyses were performed between TGC and cognitive function test performance in FEP patients. RESULTS Mean resting-state TGC was larger for the FEP patients than for the HCs. Patients with FEP showed increased TGC in the left posterior cingulate cortex, which was correlated with better performance on the TMT-A and TMT-B and on immediate and delayed recall in the CVLT. CONCLUSIONS These results suggest that patients with FEP show compensatory hyperactivation of resting-state TGC in DMN-related brain regions, which may be related to the reallocation of cognitive resources to prepare for successful cognitive execution. This study not only highlights the neural underpinnings of cognitive dysfunction in FEP patients but also provides useful background to support the development of treatments for cognitive dysfunction in schizophrenia.
Collapse
|
12
|
Bae GY, Leonard CJ, Hahn B, Gold JM, Luck SJ. Assessing the information content of ERP signals in schizophrenia using multivariate decoding methods. Neuroimage Clin 2020; 25:102179. [PMID: 31954988 PMCID: PMC6965722 DOI: 10.1016/j.nicl.2020.102179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/22/2019] [Accepted: 01/13/2020] [Indexed: 02/01/2023]
Abstract
This study took multivariate decoding methods that are widely used to assess the nature of neural representations in neurotypical people and applied them to a comparison of people with schizophrenia and matched control subjects. Participants performed a visual working memory task that required remembering 1–5 items from one side of the display and ignoring an equal number of items on the other side of the display. We attempted to decode which side was being held in working memory from the scalp distribution of the ERP activity during the delay period of the working memory task, and we found greater decoding accuracy in people with schizophrenia than in control subjects when a single item was being held in memory. These results support the hyperfocusing hypothesis of cognitive dysfunction in schizophrenia, and they provide an important proof of concept for applying multivariate decoding methods to comparisons of neural representations in psychiatric and non-psychiatric populations.
Multivariate pattern classification (decoding) methods are commonly employed to study mechanisms of neurocognitive processing in typical individuals, where they can be used to quantify the information that is present in single-participant neural signals. These decoding methods are also potentially valuable in determining how the representation of information differs between psychiatric and non-psychiatric populations. Here, we examined ERPs from people with schizophrenia (PSZ) and healthy control subjects (HCS) in a working memory task that involved remembering 1, 3, or 5 items from one side of the display and ignoring the other side. We used the spatial pattern of ERPs to decode which side of the display was being held in working memory. One might expect that decoding accuracy would be inevitably lower in PSZ as a result of increased noise (i.e., greater trial-to-trial variability). However, we found that decoding accuracy was greater in PSZ than in HCS at memory load 1, consistent with previous research in which memory-related ERP signals were larger in PSZ than in HCS at memory load 1. We also observed that decoding accuracy was strongly related to the ratio of the memory-related ERP activity and the noise level. In addition, we found similar noise levels in PSZ and HCS, counter to the expectation that PSZ would exhibit greater trial-to-trial variability. Together, these results demonstrate that multivariate decoding methods can be validly applied at the individual-participant level to understand the nature of impaired cognitive function in a psychiatric population.
Collapse
Affiliation(s)
- Gi-Yeul Bae
- Department of Psychology, Arizona State University, 950 S. McAllister Ave, Tempe, AZ 85287, USA.
| | - Carly J Leonard
- Department of Psychology, University of Colorado - Denver, USA
| | - Britta Hahn
- Maryland Psychiatric Research Center and School of Medicine, University of Maryland, USA
| | - James M Gold
- Maryland Psychiatric Research Center and School of Medicine, University of Maryland, USA
| | - Steven J Luck
- Center for Mind & Brain and Department of Psychology, University of California - Davis, USA
| |
Collapse
|
13
|
Abstract
Impairments in basic cognitive processes such as attention and working memory are commonly observed in people with schizophrenia and are predictive of long-term outcome. In this review, we describe a new theory-the hyperfocusing hypothesis-which provides a unified account of many aspects of impaired cognition in schizophrenia. This hypothesis proposes that schizophrenia involves an abnormally narrow but intense focusing of processing resources. This hyperfocusing impairs the ability of people with schizophrenia to distribute attention among multiple locations, decreases the number of representations that can simultaneously be maintained in working memory, and causes attention to be abnormally captured by irrelevant inputs that share features with active representations. Evidence supporting the hyperfocusing hypothesis comes from a variety of laboratory tasks and from both behavioral and electrophysiological measures of processing. In many of these tasks, people with schizophrenia exhibit supranormal effects of task manipulations, which cannot be explained by a generalized cognitive deficit or by nonspecific factors such as reduced motivation or poor task comprehension. In addition, the degree of hyperfocusing in these tasks is often correlated with the degree of impairment in measures of broad cognitive function, which are known to be related to long-term outcome. Thus, the mechanisms underlying hyperfocusing may be a good target for new treatments targeting cognitive deficits in schizophrenia.
Collapse
Affiliation(s)
- Steven J Luck
- Center for Mind and Brain, University of California, Davis, CA
| | - Britta Hahn
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Carly J Leonard
- Department of Psychology, University of Colorado Denver, Denver, CO
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| |
Collapse
|
14
|
Li Q, Liu S, Guo M, Yang CX, Xu Y. The Principles of Electroconvulsive Therapy Based on Correlations of Schizophrenia and Epilepsy: A View From Brain Networks. Front Neurol 2019; 10:688. [PMID: 31316456 PMCID: PMC6610531 DOI: 10.3389/fneur.2019.00688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/13/2019] [Indexed: 12/16/2022] Open
Abstract
Electroconvulsive therapy (ECT) was established based on Meduna's hypothesis that there is an antagonism between schizophrenia and epilepsy, and that the induction of a seizure could alleviate the symptoms of schizophrenia. However, subsequent investigations of the mechanisms of ECT have largely ignored this originally established relationship between these two disorders. With the development of functional magnetic resonance imaging (fMRI), brain-network studies have demonstrated that schizophrenia and epilepsy share common dysfunctions in the default-mode network (DMN), saliency network (SN), dorsal-attention network (DAN), and central-executive network (CEN). Additionally, fMRI-defined brain networks have also been shown to be useful in the evaluation of the treatment efficacy of ECT. Here, we compared the ECT-induced changes in the pathological conditions between schizophrenia and epilepsy in order to offer further insight as to whether the mechanisms of ECT are truly based on antagonistic and/or affinitive relationships between these two disorders.
Collapse
Affiliation(s)
- Qi Li
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Meng Guo
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Cheng-Xiang Yang
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,National Key Disciplines, Key Laboratory for Cellular Physiology of Ministry of Education, Department of Neurobiology, Shanxi Medical University, Taiyuan, China.,Department of Humanities and Social Science, Shanxi Medical University, Taiyuan, China
| |
Collapse
|
15
|
Gold JM, Barch DM, Feuerstahler LM, Carter CS, MacDonald AW, Ragland JD, Silverstein SM, Strauss ME, Luck SJ. Working Memory Impairment Across Psychotic disorders. Schizophr Bull 2019; 45:804-812. [PMID: 30260448 PMCID: PMC6581132 DOI: 10.1093/schbul/sby134] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Working memory (WM) has been a central focus of cognitive neuroscience research because WM is a resource that is involved in many different cognitive operations. The goal of this study was to evaluate the clinical utility of WM paradigms developed in the basic cognitive neuroscience literature, including methods designed to estimate storage capacity without contamination by lapses of attention. METHODS A total of 61 people with schizophrenia, 49 with schizoaffective disorder, 47 with bipolar disorder with psychosis, and 59 healthy volunteers were recruited. Participants received multiple WM tasks, including two versions each of a multiple Change Detection paradigm, a visual Change Localization paradigm, and a Running Span task. RESULTS Healthy volunteers performed better than the combined patient group on the visual Change Localization and running span measures. The multiple Change Detection tasks provided mixed evidence about WM capacity reduction in the patient groups, but a mathematical model of performance suggested that the patient groups differed from controls in their rate of attention lapsing. The 3 patient groups performed similarly on the WM tasks. Capacity estimates from the Change Detection and Localization tasks showed significant correlations with functional capacity and functional outcome. CONCLUSIONS The patient groups generally performed in a similarly impaired fashion across tasks, suggesting that WM impairment and attention lapsing are general features of psychotic disorders. Capacity estimates from the Change Localization and Detection tasks were related to functional capacity and outcome, suggesting that these methods may be useful in a clinical context.
Collapse
Affiliation(s)
- James M Gold
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD,To whom correspondence should be addressed: tel: 410-402-7871, fax: 410-402-7198, e-mail:
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO
| | - Leah M Feuerstahler
- Graduate School of Education, University of California at Berkeley, Berkeley, CA
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Davis, CA
| | | | - J Daniel Ragland
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Davis, CA
| | - Steven M Silverstein
- Rutgers University Behavioral Health Care, Piscataway, NJ,Robert Wood Johnson Medical School Department of Psychiatry, Rutgers University, Piscataway, NJ
| | - Milton E Strauss
- Department of Psychology, University of New Mexico, Albuquerque, NM
| | - Steven J Luck
- Department of Psychology, Center for Mind and Brain, University of California at Davis, Davis, CA
| |
Collapse
|
16
|
Salgado-Pineda P, Radua J, Sarró S, Guerrero-Pedraza A, Salvador R, Pomarol-Clotet E, McKenna PJ. Sensitivity and specificity of hypoactivations and failure of de-activation in schizophrenia. Schizophr Res 2018; 201:224-230. [PMID: 29954704 DOI: 10.1016/j.schres.2018.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 03/19/2018] [Accepted: 06/08/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Brain functional changes reported in schizophrenia include reduced prefrontal cortex activation (hypofrontality), increased frontal activation (hyperfrontality) and failure of de-activation in the medial frontal cortex. The relative importance of these changes is unestablished. METHODS A 'discovery' sample of 32 schizophrenic patients and 32 controls was used to establish regions of altered activation and de-activation in the patients. The discriminatory power of these regions was examined using receiver-operator characteristics (ROC) analysis in two 'test' samples, one of 83 patients with chronic schizophrenia and 83 healthy controls, and the other of 31 first-episode patients and 31 healthy controls. RESULTS The discovery sample revealed reduced activation in the prefrontal cortex and other regions, and failure of de-activation in the medial frontal cortex. Failure of de-activation had significantly greater power to distinguish the chronic patients from the healthy controls than hypoactivation. The pattern was similar in the first-episode patients, where additionally the discriminatory power of hypoactivation was poor. Controlling for the effects of n-back task performance tended to reduce discriminatory power overall, but this persisted for failure of de-activation in the chronic test sample. CONCLUSIONS Both hypoactivation and failure of de-activation can distinguish patients with chronic schizophrenia from healthy subjects, but the latter abnormality has more power. Failure of de-activation cannot be construed simply as a passive consequence of reduced prefrontal activation in the disorder.
Collapse
Affiliation(s)
- Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Joaquim Radua
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| |
Collapse
|
17
|
Hahn B, Robinson BM, Leonard CJ, Luck SJ, Gold JM. Posterior Parietal Cortex Dysfunction Is Central to Working Memory Storage and Broad Cognitive Deficits in Schizophrenia. J Neurosci 2018; 38:8378-87. [PMID: 30104335 DOI: 10.1523/JNEUROSCI.0913-18.2018] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/09/2018] [Accepted: 08/06/2018] [Indexed: 01/09/2023] Open
Abstract
PFC dysfunction is widely believed to underlie working memory (WM) deficits in people with schizophrenia (PSZ), but few studies have focused on measures of WM storage devoid of manipulation. Research in neurotypical individuals has shown that storage capacity is more closely related to posterior parietal cortex (PPC) than PFC, suggesting that reductions in WM storage capacity in schizophrenia that are associated with broad cognitive deficits may be related to neural activity in PPC. In the present human neuroimaging study, 37 PSZ and 37 matched healthy control subjects of either sex completed a change detection task with varying set sizes while undergoing fMRI. The task was designed to emphasize WM storage with minimal top-down control demands. Whole-brain analysis identified areas in which BOLD activity covaried with the number of items maintained in WM (K), as derived from task performance at a given set size. Across groups, K values independent of set size predicted BOLD activity in PPC, including superior and inferior parietal lobules and intraparietal sulcus, and middle occipital gyrus. Whole-brain interaction analysis found significantly less K-dependent signal modulation in PSZ than healthy control subjects in left PPC, a phenomenon that could not be explained by a narrower K value range. The slope between K and PPC activation statistically accounted for 43.4% of the between-group differences in broad cognitive function. These results indicate that PPC dysfunction is central to WM storage deficits in PSZ and may play a key role in the broad cognitive deficits associated with schizophrenia.SIGNIFICANCE STATEMENT People with schizophrenia exhibit cognitive deficits across a wide range of tasks. Explaining these impairments in terms of a small number of core deficits with clearly defined neural correlates would advance the understanding of the disorder and promote treatment development. We show that a substantial portion of broad cognitive deficits in schizophrenia can be explained by a failure to flexibly modulate posterior parietal cortex activity as a function of the amount of information currently stored in working memory. Working memory deficits have long been considered central to schizophrenia-related cognitive deficits, but the focus has been on paradigms involving some form of top-down control rather than pure storage of information, which may have unduly narrowed the focus on prefrontal dysfunction.
Collapse
|
18
|
Kustermann T, Popov T, Miller GA, Rockstroh B. Verbal working memory-related neural network communication in schizophrenia. Psychophysiology 2018; 55:e13088. [DOI: 10.1111/psyp.13088] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 01/31/2018] [Accepted: 03/12/2018] [Indexed: 12/23/2022]
Affiliation(s)
| | - Tzvetan Popov
- Department of Psychology; University of Konstanz; Konstanz Germany
| | - Gregory A. Miller
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences; University of California Los Angeles; Los Angeles California USA
| | | |
Collapse
|