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Parker DA, Imes S, Ruban G, Ousley OY, Henshey B, Massa NM, Walker E, Cubells JF, Duncan E. Reduced amplitude and slowed latency of the acoustic startle response in adolescents and adults with 22q11.2 deletion syndrome. Schizophr Res 2024; 269:9-17. [PMID: 38703519 DOI: 10.1016/j.schres.2024.04.022] [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: 10/09/2023] [Revised: 04/14/2024] [Accepted: 04/27/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS) is one of the most robust genetic predictors of psychosis and other psychiatric illnesses. In this study, we examined 22q11DS subjects' acoustic startle responses (ASRs), which putatively index psychosis risk. Latency of the ASR is a presumptive marker of neural processing speed and is prolonged (slower) in schizophrenia. ASR measures correlate with increased psychosis risk, depend on glutamate and dopamine receptor signaling, and could serve as translational biomarkers in interventions for groups at high psychosis risk. METHODS Startle magnitude, latency, and prepulse inhibition were assessed with a standard acoustic startle paradigm in 31 individuals with 22q11.2DS and 32 healthy comparison (HC) subjects. Surface electrodes placed on participants' orbicularis oculi recorded the electromyographic signal in ASR eyeblinks. Individuals without measurable startle blinks in the initial habituation block were classified as non-startlers. RESULTS Across the startle session, the ASR magnitude was significantly lower in 22q11DS subjects than HCs because a significantly higher proportion of 22q11DS subjects were non-startlers. Latency of the ASR to pulse-alone stimuli was significantly slower in 22q11DS than HC subjects. Due to the overall lower 22q11DS startle response frequency and magnitudes prepulse inhibition could not be analyzed. CONCLUSIONS Reduced magnitude and slow latency of 22q11DS subjects' responses suggest reduced central nervous system and neuronal responsiveness. These findings are consistent with significant cognitive impairments observed in 22q11DS subjects. Further research is needed to untangle the connections among basic neurotransmission dysfunction, psychophysiological responsiveness, and cognitive impairment.
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Affiliation(s)
- David Alan Parker
- Department of Human Genetics, Emory University School of Medicine, United States of America.
| | - Sid Imes
- Department of Human Genetics, Emory University School of Medicine, United States of America
| | - Gabrielle Ruban
- Department of Human Genetics, Emory University School of Medicine, United States of America
| | - Opal Yates Ousley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States of America
| | | | - Nicholas M Massa
- Atlanta Veterans Administration Health Care System, United States of America
| | - Elaine Walker
- Department of Psychology, Emory University, United States of America
| | - Joseph F Cubells
- Department of Human Genetics, Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States of America
| | - Erica Duncan
- Atlanta Veterans Administration Health Care System and Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States of America
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Foucher JR, Hirjak D, Walther S, Dormegny-Jeanjean LC, Humbert I, Mainberger O, de Billy CC, Schorr B, Vercueil L, Rogers J, Ungvari G, Waddington J, Berna F. From one to many: Hypertonia in schizophrenia spectrum psychosis an integrative review and adversarial collaboration report. Schizophr Res 2024; 263:66-81. [PMID: 37059654 DOI: 10.1016/j.schres.2023.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 04/16/2023]
Abstract
Different types of resistance to passive movement, i.e. hypertonia, were described in schizophrenia spectrum disorders (SSD) long before the introduction of antipsychotics. While these have been rediscovered in antipsychotic-naïve patients and their non-affected relatives, the existence of intrinsic hypertonia vs drug-induced parkinsonism (DIP) in treated SSD remains controversial. This integrative review seeks to develop a commonly accepted framework to specify the putative clinical phenomena, highlight conflicting issues and discuss ways to challenge each hypothesis and model through adversarial collaboration. The authors agreed on a common framework inspired from systems neuroscience. Specification of DIP, locomotor paratonia (LMP) and psychomotor paratonia (PMP) identified points of disagreement. Some viewed parkinsonian rigidity to be sufficient for diagnosing DIP, while others viewed DIP as a syndrome that should include bradykinesia. Sensitivity of DIP to anticholinergic drugs and the nature of LPM and PMP were the most debated issues. It was agreed that treated SSD should be investigated first. Clinical features of the phenomena at issue could be confirmed by torque, EMG and joint angle measures that could help in challenging the selectivity of DIP to anticholinergics. LMP was modeled as the release of the reticular formation from the control of the supplementary motor area (SMA), which could be challenged by the tonic vibration reflex or acoustic startle. PMP was modeled as the release of primary motor cortex from the control of the SMA and may be informed by subclinical echopraxia. If these challenges are not met, this would put new constraints on the models and have clinical and therapeutic implications.
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Affiliation(s)
- Jack R Foucher
- ICube - CNRS UMR 7357, Neurophysiology, FMTS, University of Strasbourg, France, EU; CEMNIS - Noninvasive Neuromodulation Center, University Hospital Strasbourg, France, EU.
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany, EU
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Ludovic C Dormegny-Jeanjean
- ICube - CNRS UMR 7357, Neurophysiology, FMTS, University of Strasbourg, France, EU; CEMNIS - Noninvasive Neuromodulation Center, University Hospital Strasbourg, France, EU
| | - Ilia Humbert
- CEMNIS - Noninvasive Neuromodulation Center, University Hospital Strasbourg, France, EU
| | - Olivier Mainberger
- ICube - CNRS UMR 7357, Neurophysiology, FMTS, University of Strasbourg, France, EU; CEMNIS - Noninvasive Neuromodulation Center, University Hospital Strasbourg, France, EU
| | - Clément C de Billy
- ICube - CNRS UMR 7357, Neurophysiology, FMTS, University of Strasbourg, France, EU; CEMNIS - Noninvasive Neuromodulation Center, University Hospital Strasbourg, France, EU
| | - Benoit Schorr
- Pôle de Psychiatrie, Santé Mentale et Addictologie, University Hospital Strasbourg, France, EU; Physiopathologie et Psychopathologie Cognitive de la Schizophrénie - INSERM 1114, FMTS, University of Strasbourg, France, EU
| | - Laurent Vercueil
- Unité de neurophysiologie clinique, CHU Grenoble Alpes, Université Grenoble Alpes, France, EU; INSERM U1216, Institut de neurosciences, Grenoble, France, EU
| | - Jonathan Rogers
- Division of Psychiatry, University College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Gabor Ungvari
- Section of Psychiatry, School of Medicine, University Notre Dame Australia, Fremantle, Australia
| | - John Waddington
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland, EU
| | - Fabrice Berna
- Pôle de Psychiatrie, Santé Mentale et Addictologie, University Hospital Strasbourg, France, EU; Physiopathologie et Psychopathologie Cognitive de la Schizophrénie - INSERM 1114, FMTS, University of Strasbourg, France, EU
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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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Pöhlchen D, Fietz J, Czisch M, Sämann PG, Spoormaker VI, Binder E, Brückl T, Erhardt A, Grandi N, Lucae S, von Muecke-Heim I, Ziebula J. Startle Latency as a Potential Marker for Amygdala-Mediated Hyperarousal. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 8:406-416. [PMID: 35577304 DOI: 10.1016/j.bpsc.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Fear-related disorders are characterized by hyperexcitability in reflexive circuits and maladaptive associative learning mechanisms. The startle reflex is suited to investigate both processes, either by probing it under baseline conditions or by deriving it in fear conditioning studies. In anxiety research, the amplitude of the fear-potentiated startle has been shown to be influenced by amygdalar circuits and has typically been the readout of interest. In schizophrenia research, prolonged startle peak latency under neutral conditions is an established readout, thought to reflect impaired processing speed. We therefore explored whether startle latency is an informative readout for human anxiety research. METHODS We investigated potential similarities and differences of startle peak latency and amplitude derived from a classical fear conditioning task in a sample of 206 participants with varying severity levels of anxiety disorders and healthy control subjects. We first reduced startle response to stable components and regressed individual amygdala gray matter volumes onto the resulting startle measures. We then probed time, stimulus, and group effects of startle latency. RESULTS We showed that startle latency and startle amplitude were 2 largely uncorrelated measures; startle latency, but not amplitude, showed a sex-specific association with gray matter volume of the amygdala; startle latencies showed a fear-dependent task modulation; and patients with fear-related disorders displayed shorter startle latencies throughout the fear learning task. CONCLUSIONS These data provide support for the notion that probing startle latencies under threat may engage amygdala-modulated threat processing, making them a complementary marker for human anxiety research.
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