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Avery SN, McHugo M, Armstrong K, Blackford JU, Woodward ND, Heckers S. Stable habituation deficits in the early stage of psychosis: a 2-year follow-up study. Transl Psychiatry 2021; 11:20. [PMID: 33414431 PMCID: PMC7791099 DOI: 10.1038/s41398-020-01167-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 01/29/2023] Open
Abstract
Neural habituation, the decrease in brain response to repeated stimuli, is a fundamental, highly conserved mechanism that acts as an essential filter for our complex sensory environment. Convergent evidence indicates neural habituation is disrupted in both early and chronic stages of schizophrenia, with deficits co-occurring in brain regions that show inhibitory dysfunction. As inhibitory deficits have been proposed to contribute to the onset and progression of illness, habituation may be an important treatment target. However, a crucial first step is clarifying whether habituation deficits progress with illness. In the present study, we measured neural habituation in 138 participants (70 early psychosis patients (<2 years of illness), 68 healthy controls), with 108 participants assessed longitudinally at both baseline and 2-year follow-up. At follow-up, all early psychosis patients met criteria for a schizophrenia spectrum disorder (i.e., schizophreniform disorder, schizophrenia, schizoaffective disorder). Habituation slopes (i.e., rate of fMRI signal change) to repeated images were computed for the anterior hippocampus, occipital cortex, and the fusiform face area. Habituation slopes were entered into a linear mixed model to test for effects of group and time by region. We found that early psychosis patients showed habituation deficits relative to healthy control participants across brain regions, and that these deficits were maintained, but did not worsen, over two years. These results suggest a stable period of habituation deficits in the early stage of schizophrenia.
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Affiliation(s)
- Suzanne N. Avery
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Maureen McHugo
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Kristan Armstrong
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Jennifer Urbano Blackford
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA ,grid.413806.8Research Health Scientist, Research and Development, Department of Veterans Affairs Medical Center, Nashville, TN USA
| | - Neil D. Woodward
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
| | - Stephan Heckers
- grid.412807.80000 0004 1936 9916Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN USA
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Salivary Alpha-Amylase Activity Levels in Catatonic Schizophrenia Decrease after Electroconvulsive Therapy. Case Rep Psychiatry 2018; 2018:2623585. [PMID: 29862108 PMCID: PMC5971272 DOI: 10.1155/2018/2623585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/30/2018] [Accepted: 02/22/2018] [Indexed: 11/18/2022] Open
Abstract
Background. Dysfunction of the autonomic nervous system (ANS) in schizophrenia has been detected by electrophysiological methods, but the underlying mechanisms remain unknown. Several studies have suggested that measuring salivary alpha-amylase activity levels is useful for evaluating the ANS activity and that sAA levels increase in schizophrenia and correlate with Brief Psychiatric Rating Scale (BPRS) scores. However, no study has examined the relationship between sAA activity levels and symptoms of schizophrenia with catatonic state. Methods. We present the case of a 59-year-old female with persistent catatonic schizophrenia treated by electroconvulsive therapy. We evaluated the ANS activity by measuring sAA activity levels before and after ECT, and we evaluated her symptoms using the BPRS and Bush–Francis Catatonia Rating Scale (BFCRS). Results. ECT was highly effective and BPRS and BFCRS scores substantially decreased. sAA activity levels decreased from 125 kU/l to 33 kU/l. Conclusions. sAA activity levels could be a potential biomarker of schizophrenia with catatonic state.
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McDiarmid TA, Bernardos AC, Rankin CH. Habituation is altered in neuropsychiatric disorders-A comprehensive review with recommendations for experimental design and analysis. Neurosci Biobehav Rev 2017; 80:286-305. [PMID: 28579490 DOI: 10.1016/j.neubiorev.2017.05.028] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/29/2017] [Indexed: 02/03/2023]
Abstract
Abnormalities in the simplest form of learning, habituation, have been reported in a variety of neuropsychiatric disorders as etiologically diverse as Autism Spectrum Disorder, Fragile X syndrome, Schizophrenia, Parkinson's Disease, Huntington's Disease, Attention Deficit Hyperactivity Disorder, Tourette's Syndrome, and Migraine. Here we provide the first comprehensive review of what is known about alterations in this form of non-associative learning in each disorder. Across several disorders, abnormal habituation is predictive of symptom severity, highlighting the clinical significance of habituation and its importance to normal cognitive function. Abnormal habituation is discussed within the greater framework of learning theory and how it may relate to disease phenotype either as a cause, symptom, or therapy. Important considerations for the design and interpretation of habituation experiments are outlined with the hope that these will aid both clinicians and basic researchers investigating how this simple form of learning is altered in disease.
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Affiliation(s)
- Troy A McDiarmid
- Graduate Program in Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Rm F221, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Aram C Bernardos
- Graduate Program in Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Rm F221, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Catharine H Rankin
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Rm F221, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada.
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Mathewson KJ, Jetha MK, Goldberg JO, Schmidt LA. Autonomic regulation predicts performance on Wisconsin Card Sorting Test (WCST) in adults with schizophrenia. Biol Psychol 2012; 91:389-99. [PMID: 23000567 DOI: 10.1016/j.biopsycho.2012.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 06/06/2012] [Accepted: 09/01/2012] [Indexed: 12/13/2022]
Abstract
Although executive functions have been associated with autonomic regulatory capacity in healthy adults, there appear to be no reports of these relations in adults with schizophrenia to date. We tested whether baseline autonomic regulation was associated with performance on the Wisconsin Card Sorting Test (WCST) in a group of 42 stable community outpatients with schizophrenia. Patients exhibited faster resting heart rates and lower respiratory sinus arrhythmia (RSA) than age-matched controls, consistent with previous research. Patients also completed relatively few WCST categories and made many perseverative errors, replicating prior studies. Within the patient group, relatively better WCST performance was associated with slower resting heart rate and higher RSA, suggesting that inefficient executive and autonomic functioning in schizophrenia may be linked. WCST performance and autonomic regulatory capacity were further reduced in a subset of patients receiving clozapine, but relations between WCST performance and autonomic regulatory parameters did not differ from those of other patients. Findings extend the neurovisceral integration model of autonomic regulation to adults with schizophrenia and attest to the reliability of the model.
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Affiliation(s)
- Karen J Mathewson
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada L8S 4K1.
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Beat-to-beat heart rate and QT interval variability in first episode neuroleptic-naive psychosis. Schizophr Res 2009; 113:176-80. [PMID: 19570654 PMCID: PMC2829670 DOI: 10.1016/j.schres.2009.06.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2009] [Revised: 06/02/2009] [Accepted: 06/03/2009] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Though increased risk of sudden death in patients with schizophrenia is well-documented, the mechanisms remain unclear. Recent studies report two known risk factors for sudden cardiac death and other arrhythmias in schizophrenia, i.e., decreased RR interval variability (RRV) and increased QT interval variability (QTV). However, these studies did not control for the effects of medication. Herein, we report the results of our study comparing RRV and QTV in first episode neuroleptic-naive psychosis patients with healthy matched controls. METHODS 24 patients with first episode neuroleptic naïve psychosis were matched with 26 healthy controls on age and gender. After an overnight fast, all participants underwent an electrocardiogram recording in the morning. RESULTS In comparison with matched controls, patients with first episode neuroleptic-naïve psychosis had significantly increased QTV corrected for RRV, and decreased RRV. CONCLUSIONS The observed alterations in RRV and QTV may reflect impaired cardiac autonomic function that could underlie risk for abnormal ventricular repolarization and thereby increase the risk of sudden death and other arrhythmias. Our data suggest that RRV and QTV alterations may be independent of medication effects in first episode psychosis patients.
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Li CSR. Do schizophrenia patients make more perseverative than non-perseverative errors on the Wisconsin Card Sorting Test? A meta-analytic study. Psychiatry Res 2004; 129:179-90. [PMID: 15590045 DOI: 10.1016/j.psychres.2004.06.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2004] [Revised: 06/01/2004] [Accepted: 06/02/2004] [Indexed: 10/26/2022]
Abstract
The Wisconsin Card Sorting Test (WCST) is widely used to explore executive functions in patients with schizophrenia. Among other findings, a higher number of perseverative errors has been suggested to implicate a deficit in task switching and inhibitory functions in schizophrenia. Many studies of patients with schizophrenia have focused on perseverative errors as the primary performance index in the WCST. However, do schizophrenia patients characteristically make more perseverative than non-perseverative errors compared with healthy controls? We reviewed the literature where schizophrenia patients were engaged in the WCST irrespective of the primary goal of the study. The results showed that while both schizophrenia patients and healthy participants made more perseverative than non-perseverative errors, the contrast between perseverative and non-perseverative errors is higher in schizophrenia patients only at a marginal level of significance. This result suggests that schizophrenia patients do make a comparable number of non-perseverative errors and cautions against simplistic interpretation of poor performance of schizophrenia patients in WCST as entirely resulting from impairment in set-shifting or inhibitory functions.
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Affiliation(s)
- Chiang-Shan Ray Li
- Connecticut Mental Health Center, Department of Psychiatry, Yale University, Rm. S103, 34 Park Street, New Haven, CT 06519, USA.
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Valkonen-Korhonen M, Könönen M, Yppärilä H, Sipilä P, Lehtonen J, Partanen J, Tarkka IM, Karhu J. Cerebral signs of altered adaptability in females with acute psychosis. Schizophr Res 2002; 55:291-301. [PMID: 12048153 DOI: 10.1016/s0920-9964(01)00282-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In psychosis, behavior is not guided by sensory cues from surroundings. Novel, meaningful behaviors require intact integrative functions such as short-term memory and motor planning, as well as an optimized level of arousal. In this study, we monitored markers of automatic auditory processing in 15 female never-medicated psychotic patients. Fifty-eight channels of EEG were recorded simultaneously with sympathetic skin responses while arousing auditory stimuli were delivered. Neuropsychological tests concentrating on frontal lobe functions were also performed. Prominent neurophysiological and behavioral signs of increased cortical activation were observed in psychotic patients. This widespread disinhibition may attempt to compensate for the impairment of neuronal processing of sensory input from surroundings in the earliest stages of a psychotic illness.
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Valkonen-Korhonen M, Karjalainen P, Lehtonen J, Koistinen A, Partanen J, Karhu J. Loss of time-organized sympathetic skin responses in acute psychosis. J Nerv Ment Dis 2001; 189:552-6. [PMID: 11531208 DOI: 10.1097/00005053-200108000-00009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The aim of this study was to differentiate the response pattern characteristics of sympathetic skin responses (SSR) between unmedicated first psychotic subjects and healthy controls. We recorded SSR to novel auditory stimuli in 13 psychotic subjects and in 19 controls. There was no constant delay between a sudden change in the acoustic surroundings and SSR in psychotic subjects, whereas regularly this delay was 1.3 to 1.8 seconds in controls. The validity of the test was evaluated by blind rating responses to two categories. The lack of a regular time delay between a novel auditory stimulus and SSR suggests a timing disturbance in the neural networks regulating the autonomic nervous system responses in acute psychosis. Our finding and method may have future implications in evaluation of subtle autonomic nervous system alterations related, e.g., to drug effects.
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Affiliation(s)
- M Valkonen-Korhonen
- Department of Psychiatry, University of Kuopio, Kuopio University Hospital, Finland
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Papousek I, Schulter G. Associations between EEG asymmetries and electrodermal lability in low vs. high depressive and anxious normal individuals. Int J Psychophysiol 2001; 41:105-17. [PMID: 11325456 DOI: 10.1016/s0167-8760(01)00131-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In order to investigate one aspect of cortical-autonomic control, cortical activation asymmetries, measured by EEG, were related to activity of the sympathetic nervous system, measured by EDA (electrodermal lability, number of spontaneous fluctuations), in two large samples. Since it may help to explain the participation of psychological factors in the development of various somatic complaints and disorders, we examined whether inter-individual differences in autonomic nervous system regulation may exist that are related to stress/anxiety and depression within the normal range. Results demonstrate substantial modifications of functional hemisphere asymmetries in the modulation of EDA by these emotional factors and suggest that activation asymmetries in orbital and dorsolateral frontal regions reflect two different cortical sub-systems regulating electrodermal activity. The findings may, to some extent, provide an explanation for contradictory results in previous studies and may encourage research in psychosomatics and other clinical fields (e.g. schizophrenia).
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Affiliation(s)
- I Papousek
- University of Graz, Department of Psychology, Univ.-Platz 2, 8010, Graz, Austria.
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