1
|
Menon V, Palaniyappan L, Supekar K. Integrative Brain Network and Salience Models of Psychopathology and Cognitive Dysfunction in Schizophrenia. Biol Psychiatry 2022:S0006-3223(22)01637-7. [PMID: 36702660 DOI: 10.1016/j.biopsych.2022.09.029] [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: 03/25/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 01/28/2023]
Abstract
Brain network models of cognitive control are central to advancing our understanding of psychopathology and cognitive dysfunction in schizophrenia. This review examines the role of large-scale brain organization in schizophrenia, with a particular focus on a triple-network model of cognitive control and its role in aberrant salience processing. First, we provide an overview of the triple network involving the salience, frontoparietal, and default mode networks and highlight the central role of the insula-anchored salience network in the aberrant mapping of salient external and internal events in schizophrenia. We summarize the extensive evidence that has emerged from structural, neurochemical, and functional brain imaging studies for aberrancies in these networks and their dynamic temporal interactions in schizophrenia. Next, we consider the hypothesis that atypical striatal dopamine release results in misattribution of salience to irrelevant external stimuli and self-referential mental events. We propose an integrated triple-network salience-based model incorporating striatal dysfunction and sensitivity to perceptual and cognitive prediction errors in the insula node of the salience network and postulate that dysregulated dopamine modulation of salience network-centered processes contributes to the core clinical phenotype of schizophrenia. Thus, a powerful paradigm to characterize the neurobiology of schizophrenia emerges when we combine conceptual models of salience with large-scale cognitive control networks in a unified manner. We conclude by discussing potential therapeutic leads on restoring brain network dysfunction in schizophrenia.
Collapse
Affiliation(s)
- Vinod Menon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University School of Medicine, Stanford, California.
| | - Lena Palaniyappan
- Department of Psychiatry and Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Kaustubh Supekar
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Wu Tsai Neurosciences Institute, Stanford University School of Medicine, Stanford, California
| |
Collapse
|
2
|
Eum S, Hill SK, Alliey-Rodriguez N, Stevenson JM, Rubin LH, Lee AM, Mills LJ, Reilly JL, Lencer R, Keedy SK, Ivleva E, Keefe RSE, Pearlson GD, Clementz BA, Tamminga CA, Keshavan MS, Gershon ES, Sweeney JA, Bishop JR. Genome-wide association study accounting for anticholinergic burden to examine cognitive dysfunction in psychotic disorders. Neuropsychopharmacology 2021; 46:1802-1810. [PMID: 34145405 PMCID: PMC8358015 DOI: 10.1038/s41386-021-01057-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/17/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022]
Abstract
Identifying genetic contributors to cognitive impairments in psychosis-spectrum disorders can advance understanding of disease pathophysiology. Although CNS medications are known to affect cognitive performance, they are often not accounted for in genetic association studies. In this study, we performed a genome-wide association study (GWAS) of global cognitive performance, measured as composite z-scores from the Brief Assessment of Cognition in Schizophrenia (BACS), in persons with psychotic disorders and controls (N = 817; 682 cases and 135 controls) from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. Analyses accounting for anticholinergic exposures from both psychiatric and non-psychiatric medications revealed five significantly associated variants located at the chromosome 3p21.1 locus, with the top SNP rs1076425 in the inter-alpha-trypsin inhibitor heavy chain 1 (ITIH1) gene (P = 3.25×E-9). The inclusion of anticholinergic burden improved association models (P < 0.001) and the number of significant SNPs identified. The effect sizes and direction of effect of the top variants remained consistent when investigating findings within individuals receiving specific antipsychotic drugs and after accounting for antipsychotic dose. These associations were replicated in a separate study sample of untreated first-episode psychosis. The chromosome 3p21.1 locus was previously reported to have association with the risk for psychotic disorders and cognitive performance in healthy individuals. Our findings suggest that this region may be a psychosis risk locus that is associated with cognitive mechanisms. Our data highlight the general point that the inclusion of medication exposure information may improve the detection of gene-cognition associations in psychiatric genetic research.
Collapse
Affiliation(s)
- Seenae Eum
- grid.412555.20000 0001 0511 4494Department of Pharmacogenomics, Shenandoah University, Fairfax, VA USA
| | - S. Kristian Hill
- grid.262641.50000 0004 0388 7807Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL USA
| | - Ney Alliey-Rodriguez
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL USA
| | - James M. Stevenson
- grid.21107.350000 0001 2171 9311Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Leah H. Rubin
- grid.21107.350000 0001 2171 9311Departments of Neurology, Psychiatry, and Epidemiology, Johns Hopkins University, Baltimore, MD USA
| | - Adam M. Lee
- grid.17635.360000000419368657Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN USA
| | - Lauren J. Mills
- grid.17635.360000000419368657Masonic Cancer Center and Department of Pediatrics, University of Minnesota, Minneapolis, MN USA
| | - James L. Reilly
- grid.16753.360000 0001 2299 3507Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL USA
| | - Rebekka Lencer
- grid.5949.10000 0001 2172 9288Institute of Translational Psychiatry and Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany ,grid.4562.50000 0001 0057 2672Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Sarah K. Keedy
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL USA
| | - Elena Ivleva
- grid.267313.20000 0000 9482 7121Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX USA
| | - Richard S. E. Keefe
- grid.26009.3d0000 0004 1936 7961Department of Psychiatry, Duke University School of Medicine, Durham, NC USA
| | - Godfrey D. Pearlson
- grid.277313.30000 0001 0626 2712Departments of Psychiatry and Neuroscience, Yale School of Medicine, Olin Center, Institute of Living, Hartford Healthcare, Hartford, CT USA
| | - Brett A. Clementz
- grid.213876.90000 0004 1936 738XDepartment of Psychology, University of Georgia, Athens, GA USA
| | - Carol A. Tamminga
- grid.267313.20000 0000 9482 7121Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX USA
| | - Matcheri S. Keshavan
- grid.239395.70000 0000 9011 8547Beth Israel Deaconess Medical Center, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Elliot S. Gershon
- grid.170205.10000 0004 1936 7822Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL USA
| | - John A. Sweeney
- grid.413561.40000 0000 9881 9161Department of Psychiatry, University of Cincinnati Medical Center, Cincinnati, OH USA
| | - Jeffrey R. Bishop
- grid.17635.360000000419368657Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN USA ,grid.17635.360000000419368657Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN USA
| |
Collapse
|