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Attademo L, Bernardini F, Verdolini N. Neural Correlates of Schizotypal Personality Disorder: a Systematic Review of Neuroimaging and EEG Studies. Curr Med Imaging 2021; 17:1283-1298. [PMID: 33459241 DOI: 10.2174/1573405617666210114142206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/20/2020] [Accepted: 11/12/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Schizotypal personality disorder (SPD) is a cluster A personality disorder affecting 1.0% of general population, characterised by disturbances in cognition and reality testing dimensions, affect regulation, and interpersonal function. SPD shares similar but attenuated phenomenological, genetic, and neurobiological abnormalities with schizophrenia (SCZ) and is described as part of schizophrenia spectrum disorders. OBJECTIVE Aim of this work was to identify the major neural correlates of SPD. METHODS This is a systematic review conducted according to PRISMA statement. The protocol was prospectively registered in PROSPERO - International prospective register of systematic reviews. The review was performed to summarise the most comprehensive and updated evidence on functional neuroimaging and neurophysiology findings obtained through different techniques (DW-MRI, DTI, PET, SPECT, fMRI, MRS, EEG) in individuals with SPD. RESULTS Of the 52 studies included in this review, 9 were on DW-MRI and DTI, 11 were on PET and SPECT, 11 were on fMRI and MRS, and 21 were on EEG. It was complex to synthesise all the functional abnormalities found into a single, unified, pathogenetic pathway, but a common theme emerged: the dysfunction of brain circuits including striatal, frontal, temporal, limbic regions (and their networks) together with a dysregulation along the dopaminergic pathways. CONCLUSION Brain abnormalities in SPD are similar, but less marked, than those found in SCZ. Furthermore, different patterns of functional abnormalities in SPD and SCZ have been found, confirming the previous literature on the 'presence' of possible compensatory factors, protecting individuals with SPD from frank psychosis and providing diagnostic specificity.
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Affiliation(s)
- Luigi Attademo
- Hospital Psychiatric Service for Diagnosis and Care (S.P.D.C.) of Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, Potenza. Italy
| | - Francesco Bernardini
- Hospital Psychiatric Service for Diagnosis and Care (S.P.D.C.) of Pordenone, Department of Mental Health, AsFO Friuli Occidentale, Italian National Health Service, Pordenone. Italy
| | - Norma Verdolini
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st., Barcelona, Catalunya. Spain
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2
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Casquero-Veiga M, García-García D, MacDowell KS, Pérez-Caballero L, Torres-Sánchez S, Fraguas D, Berrocoso E, Leza JC, Arango C, Desco M, Soto-Montenegro ML. Risperidone administered during adolescence induced metabolic, anatomical and inflammatory/oxidative changes in adult brain: A PET and MRI study in the maternal immune stimulation animal model. Eur Neuropsychopharmacol 2019; 29:880-896. [PMID: 31229322 DOI: 10.1016/j.euroneuro.2019.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 04/30/2019] [Accepted: 05/29/2019] [Indexed: 12/22/2022]
Abstract
Inflammation and oxidative stress (IOS) are considered key pathophysiological elements in the development of mental disorders. Recent studies demonstrated that the antipsychotic risperidone elicits an antiinflammatory effect in the brain. We administered risperidone for 2-weeks at adolescence to assess its role in preventing brain-related IOS changes in the maternal immune stimulation (MIS) model at adulthood. We also investigated the development of volumetric and neurotrophic abnormalities in areas related to the HPA-axis. Poly I:C (MIS) or saline (Sal) were injected into pregnant Wistar rats on GD15. Male offspring received risperidone or vehicle daily from PND35-PND49. We studied 4 groups (8-15 animals/group): Sal-vehicle, MIS-vehicle, Sal-risperidone and MIS-risperidone. [18F]FDG-PET and MRI studies were performed at adulthood and analyzed using SPM12 software. IOS and neurotrophic markers were measured using WB and ELISA assays in brain tissue. Risperidone elicited a protective function of schizophrenia-related IOS deficits. In particular, risperidone elicited the following effects: reduced volume in the ventricles and the pituitary gland; reduced glucose metabolism in the cerebellum, periaqueductal gray matter, and parietal cortex; higher FDG uptake in the cingulate cortex, hippocampus, thalamus, and brainstem; reduced NFκB activity and iNOS expression; and increased enzymatic activity of CAT and SOD in some brain areas. Our study suggests that some schizophrenia-related IOS changes can be prevented in the MIS model. It also stresses the need to search for novel strategies based on anti-inflammatory compounds in risk populations at early stages in order to alter the course of the disease.
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Affiliation(s)
- Marta Casquero-Veiga
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - David García-García
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid, Leganés, Spain; Facultad de Ciencia y Tecnología, Universidad Isabel I, Burgos, Spain
| | - Karina S MacDowell
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Department of Pharmacology & Toxicology, School of Medicine, Universidad Complutense (UCM), IIS Imas12, IUIN, Madrid, Spain
| | - Laura Pérez-Caballero
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Neuropsychopharmacology & Psychobiology Research Group, Psychobiology Area, Department of Psychology, Universidad de Cádiz, Puerto Real (Cádiz), Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Sonia Torres-Sánchez
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain; Neuropsychopharmacology & Psychobiology Research Group, Universidad de Cádiz, Cádiz, Spain
| | - David Fraguas
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense (UCM), Madrid, Spain
| | - Esther Berrocoso
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Neuropsychopharmacology & Psychobiology Research Group, Psychobiology Area, Department of Psychology, Universidad de Cádiz, Puerto Real (Cádiz), Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Juan C Leza
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Department of Pharmacology & Toxicology, School of Medicine, Universidad Complutense (UCM), IIS Imas12, IUIN, Madrid, Spain
| | - Celso Arango
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense (UCM), Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid, Leganés, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, CNIC, Madrid, Spain.
| | - María Luisa Soto-Montenegro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER de Salud Mental (CIBERSAM), Madrid, Spain
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3
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Hazlett EA, Vaccaro DH, Haznedar MM, Goldstein KE. Reprint of: F-18Fluorodeoxyglucose positron emission tomography studies of the schizophrenia spectrum: The legacy of Monte S. Buchsbaum, M.D. Psychiatry Res 2019; 277:39-44. [PMID: 31229307 DOI: 10.1016/j.psychres.2019.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 12/12/2022]
Abstract
This is a selective review of the work of Buchsbaum and colleagues. It revisits and pays tribute to four decades of publications employing positron emission tomography (PET) with F-18fluorodeoxyglucose (FDG) to examine the neurobiology of schizophrenia-spectrum disorders (including schizotypal personality disorder (SPD) and schizophrenia). Beginning with a landmark FDG-PET study in 1982 reporting hypofrontality in unmedicated schizophrenia patients, Buchsbaum and colleagues published high-impact work on regional glucose metabolic rate (GMR) abnormalities in the spectrum. Several key discoveries were made, including the delineation of schizophrenia-spectrum abnormalities in frontal and temporal lobe, cingulate, thalamus, and striatal regions using three-dimensional mapping with coregistered MRI and PET. These findings indicated that SPD patients have less marked frontal lobe and striatal dysfunction compared with schizophrenia patients, possibly mitigating frank psychosis. Additionally, these investigations were among the first to conduct early seed-based functional connectivity analyses with FDG-PET, showing aberrant cortical-subcortical circuitry and, in particular, revealing a thalamocortical circuitry abnormality in schizophrenia. Finally, pioneering work employing the first double-blind randomized antipsychotic (haloperidol) vs. placebo FDG-PET study design in schizophrenia indicated that GMR in the striatum, more than in any other region, was related to clinical response.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States.
| | - Daniel H Vaccaro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States
| | - M Mehmet Haznedar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States
| | - Kim E Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States
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4
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Hazlett EA, Vaccaro DH, Haznedar MM, Goldstein KE. F-18Fluorodeoxyglucose positron emission tomography studies of the schizophrenia spectrum: The legacy of Monte S. Buchsbaum, M.D. Psychiatry Res 2019; 271:535-540. [PMID: 30553101 DOI: 10.1016/j.psychres.2018.12.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Abstract
This is a selective review of the work of Buchsbaum and colleagues. It revisits and pays tribute to four decades of publications employing positron emission tomography (PET) with F-18fluorodeoxyglucose (FDG) to examine the neurobiology of schizophrenia-spectrum disorders (including schizotypal personality disorder (SPD) and schizophrenia). Beginning with a landmark FDG-PET study in 1982 reporting hypofrontality in unmedicated schizophrenia patients, Buchsbaum and colleagues published high-impact work on regional glucose metabolic rate (GMR) abnormalities in the spectrum. Several key discoveries were made, including the delineation of schizophrenia-spectrum abnormalities in frontal and temporal lobe, cingulate, thalamus, and striatal regions using three-dimensional mapping with coregistered MRI and PET. These findings indicated that SPD patients have less marked frontal lobe and striatal dysfunction compared with schizophrenia patients, possibly mitigating frank psychosis. Additionally, these investigations were among the first to conduct early seed-based functional connectivity analyses with FDG-PET, showing aberrant cortical-subcortical circuitry and, in particular, revealing a thalamocortical circuitry abnormality in schizophrenia. Finally, pioneering work employing the first double-blind randomized antipsychotic (haloperidol) vs. placebo FDG-PET study design in schizophrenia indicated that GMR in the striatum, more than in any other region, was related to clinical response.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States.
| | - Daniel H Vaccaro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States
| | - M Mehmet Haznedar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States
| | - Kim E Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (VISN 2), James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, United States
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5
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Evans DW, Michael AM, Ularević M, Lusk LG, Buirkle JM, Moore GJ. Neural substrates of a schizotypal spectrum in typically-developing children: Further evidence of a normal-pathological continuum. Behav Brain Res 2016; 315:141-6. [DOI: 10.1016/j.bbr.2016.08.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 08/15/2016] [Accepted: 08/16/2016] [Indexed: 11/28/2022]
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6
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Matsui M, Sumiyoshi T, Kato K, Yoneyama E, Kurachi M. Neuropsychological Profile in Patients with Schizotypal Personality Disorder or Schizophrenia. Psychol Rep 2016; 94:387-97. [PMID: 15154161 DOI: 10.2466/pr0.94.2.387-397] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Neuropsychological impairments have been consistently reported in patients with schizophrenia. As little is known whether subjects with schizotypal personality disorder exhibit neurocognitive dysfunction similar to that in schizophrenia, we assessed the neuropsychological profile of 15 subjects with schizotypal personality disorder and compared it with that for 15 patients with schizophrenia and for 15 psychiatrically normal volunteers. All participants were administered a standard neuropsychological battery assessing language ability, spatial ability, visuomotor function, verbal memory, visual memory, auditory attention, visual attention, and executive function. Performance on most of the cognitive domains was impaired in patients with schizotypal personality disorder but less than patients with schizophrenia. Specifically, impairment in verbal memory and visuomotor ability in patients with schizotypal personality disorder and patients with schizophrenia were comparable, while patients with schizophrenia performed worse on the test of executive function than did patients with schizotypal personality disorder. As a whole, cognitive deficits in patients with schizotypal personality disorder were qualitatively similar to, but quantitatively milder than, those for patients with schizophrenia. The results suggest that cognitive abilities related to frontotemporal lobe function are disturbed across these schizophrenia-spectrum disorders.
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Affiliation(s)
- Mié Matsui
- Department of Psychology, School of Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
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7
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Via E, Orfila C, Pedreño C, Rovira A, Menchón JM, Cardoner N, Palao DJ, Soriano-Mas C, Obiols JE. Structural alterations of the pyramidal pathway in schizoid and schizotypal cluster A personality disorders. Int J Psychophysiol 2016; 110:163-170. [PMID: 27535345 DOI: 10.1016/j.ijpsycho.2016.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 07/21/2016] [Accepted: 08/12/2016] [Indexed: 12/14/2022]
Abstract
AIM Schizoid (ScPD) and Schizotypal (SPD) personality disorders are rare and severe disorders. They are associated with high liability to schizophrenia and present an attenuated form of its negative symptoms, which are considered a putative endophenotype for schizophrenia. The trans-diagnostic study of negative symptoms in non-psychotic populations such as ScPD/SPD might provide useful markers of a negative-symptom domain; however, little is known about their neurobiological substrates. The aim of the study was to investigate differences in gray and white matter volumes in subjects with ScPD/SPD compared to a group of healthy controls. METHODS Structural magnetic resonance images were obtained from 20 never-psychotic subjects with ScPD/SPD and 28 healthy controls. Resulting values from clusters of differences were correlated in patients with relevant clinical variables (O-LIFE scale). RESULTS ScPD/SPD presented greater bilateral white matter volume compared to healthy controls in the superior part of the corona radiata, close to motor/premotor regions, which correlated with the O-LIFE subtest of cognitive disorganization. No differences were found in regional gray matter or global gray/white matter volumes. CONCLUSION Greater volumes in motor pathways might relate to cognitive symptoms and motor alterations commonly present in schizophrenia-related disorders. Given the established link between motor signs and psychosis, structural alterations in motor pathways are suggested as a putative biomarker of a negative-symptom domain in psychosis subject to further testing.
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Affiliation(s)
- Esther Via
- Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain
| | - Carles Orfila
- Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Carla Pedreño
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Spain
| | - Antoni Rovira
- UDIAT Diagnostic Center, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - José M Menchón
- Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Narcís Cardoner
- Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain; UDIAT Diagnostic Center, Corporació Sanitària Parc Taulí, Sabadell, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Spain
| | - Diego J Palao
- Mental Health, Parc Taulí Sabadell-CIBERSAM, University Hospital, Sabadell, Barcelona, Spain
| | - Carles Soriano-Mas
- Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
| | - Jordi E Obiols
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Spain.
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Györffy BA, Gulyássy P, Gellén B, Völgyi K, Madarasi D, Kis V, Ozohanics O, Papp I, Kovács P, Lubec G, Dobolyi Á, Kardos J, Drahos L, Juhász G, Kékesi KA. Widespread alterations in the synaptic proteome of the adolescent cerebral cortex following prenatal immune activation in rats. Brain Behav Immun 2016; 56:289-309. [PMID: 27058163 DOI: 10.1016/j.bbi.2016.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/23/2016] [Accepted: 04/04/2016] [Indexed: 01/08/2023] Open
Abstract
An increasing number of studies have revealed associations between pre- and perinatal immune activation and the development of schizophrenia and autism spectrum disorders (ASDs). Accordingly, neuroimmune crosstalk has a considerably large impact on brain development during early ontogenesis. While a plethora of heterogeneous abnormalities have already been described in established maternal immune activation (MIA) rodent and primate animal models, which highly correlate to those found in human diseases, the underlying molecular background remains obscure. In the current study, we describe the long-term effects of MIA on the neocortical pre- and postsynaptic proteome of adolescent rat offspring in detail. Molecular differences were revealed in sub-synaptic fractions, which were first thoroughly characterized using independent methods. The widespread proteomic examination of cortical samples from offspring exposed to maternal lipopolysaccharide administration at embryonic day 13.5 was conducted via combinations of different gel-based proteomic techniques and tandem mass spectrometry. Our experimentally validated proteomic data revealed more pre- than postsynaptic protein level changes in the offspring. The results propose the relevance of altered synaptic vesicle recycling, cytoskeletal structure and energy metabolism in the presynaptic region in addition to alterations in vesicle trafficking, the cytoskeleton and signal transduction in the postsynaptic compartment in MIA offspring. Differing levels of the prominent signaling regulator molecule calcium/calmodulin-dependent protein kinase II in the postsynapse was validated and identified specifically in the prefrontal cortex. Finally, several potential common molecular regulators of these altered proteins, which are already known to be implicated in schizophrenia and ASD, were identified and assessed. In summary, unexpectedly widespread changes in the synaptic molecular machinery in MIA rats were demonstrated which might underlie the pathological cortical functions that are characteristic of schizophrenia and ASD.
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Affiliation(s)
- Balázs A Györffy
- Laboratory of Proteomics, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary; MTA-ELTE NAP B Neuroimmunology Research Group, Department of Biochemistry, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary
| | - Péter Gulyássy
- MTA-TTK NAP B MS Neuroproteomics Group, Hungarian Academy of Sciences, Budapest H-1117, Hungary; Department of Pediatrics, Medical University of Vienna, Vienna A-1090, Austria
| | - Barbara Gellén
- Laboratory of Proteomics, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary; MTA-ELTE NAP B Laboratory of Molecular and Systems Neurobiology, Institute of Biology, Hungarian Academy of Sciences and Eötvös Loránd University, Budapest H-1117, Hungary
| | - Katalin Völgyi
- Laboratory of Proteomics, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary; MTA-ELTE NAP B Laboratory of Molecular and Systems Neurobiology, Institute of Biology, Hungarian Academy of Sciences and Eötvös Loránd University, Budapest H-1117, Hungary
| | - Dóra Madarasi
- Laboratory of Proteomics, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary
| | - Viktor Kis
- Department of Anatomy, Cell and Developmental Biology, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary
| | - Olivér Ozohanics
- MTA-TTK NAP B MS Neuroproteomics Group, Hungarian Academy of Sciences, Budapest H-1117, Hungary
| | | | | | - Gert Lubec
- Department of Pediatrics, Medical University of Vienna, Vienna A-1090, Austria
| | - Árpád Dobolyi
- MTA-ELTE NAP B Laboratory of Molecular and Systems Neurobiology, Institute of Biology, Hungarian Academy of Sciences and Eötvös Loránd University, Budapest H-1117, Hungary
| | - József Kardos
- MTA-ELTE NAP B Neuroimmunology Research Group, Department of Biochemistry, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary
| | - László Drahos
- MTA-TTK NAP B MS Neuroproteomics Group, Hungarian Academy of Sciences, Budapest H-1117, Hungary
| | - Gábor Juhász
- Laboratory of Proteomics, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary; MTA-TTK NAP B MS Neuroproteomics Group, Hungarian Academy of Sciences, Budapest H-1117, Hungary
| | - Katalin A Kékesi
- Laboratory of Proteomics, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary; Department of Physiology and Neurobiology, Institute of Biology, Eötvös Loránd University, Budapest H-1117, Hungary.
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Liu K, Zhang T, Zhang Q, Sun Y, Wu J, Lei Y, Chu WCW, Mok VCT, Wang D, Shi L. Characterization of the Fiber Connectivity Profile of the Cerebral Cortex in Schizotypal Personality Disorder: A Pilot Study. Front Psychol 2016; 7:809. [PMID: 27303358 PMCID: PMC4884735 DOI: 10.3389/fpsyg.2016.00809] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/13/2016] [Indexed: 12/22/2022] Open
Abstract
Schizotypal personality disorder (SPD) is considered one of the classic disconnection syndromes. However, the specific cortical disconnectivity pattern has not been fully investigated. In this study, we aimed to explore significant alterations in whole-cortex structural connectivity in SPD individuals (SPDs) by combining the techniques of brain surface morphometry and white matter tractography. Diffusion and structural MR data were collected from 20 subjects with SPD (all males; age, 19.7 ± 0.9 years) and 18 healthy controls (all males; age, 20.3 ± 1.0 years). To measure the structural connectivity for a given unit area of the cortex, the fiber connectivity density (FiCD) value was proposed and calculated as the sum of the fractional anisotropy of all the fibers connecting to that unit area in tractography. Then, the resultant whole-cortex FiCD maps were compared in a vertex-wise manner between SPDs and controls. Compared with normal controls, SPDs showed significantly decreased FiCD in the rostral middle frontal gyrus (crossing BA 9 and BA 10) and significantly increased FiCD in the anterior part of the fusiform/inferior temporal cortex (P < 0.05, Monte Carlo simulation corrected). Moreover, the gray matter volume extracted from the left rostral middle frontal cluster was observed to be significantly greater in the SPD group (P = 0.02). Overall, this study identifies a decrease in connectivity in the left middle frontal cortex as a key neural deficit at the whole-cortex level in SPD, thus providing insight into its neuropathological basis.
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Affiliation(s)
- Kai Liu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong Hong Kong, China
| | - Teng Zhang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong Hong Kong, China
| | - Qing Zhang
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University Dalian, China
| | - Yueji Sun
- Department of Psychiatry and Behavioral Sciences, Dalian Medical University Dalian, China
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University Dalian, China
| | - Yi Lei
- Department of Radiology, The Second People's Hospital of Shenzhen Shenzhen, China
| | - Winnie C W Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong KongHong Kong, China; Shenzhen Research Institute, The Chinese University of Hong KongShenzhen, China
| | - Vincent C T Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong Hong Kong, China
| | - Defeng Wang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong KongHong Kong, China; Shenzhen Research Institute, The Chinese University of Hong KongShenzhen, China; Research Center for Medical Image Computing, The Chinese University of Hong KongHong Kong, China
| | - Lin Shi
- Department of Medicine and Therapeutics, The Chinese University of Hong KongHong Kong, China; Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong KongHong Kong, China
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Nenadic I, Lorenz C, Langbein K, Dietzek M, Smesny S, Schönfeld N, Fañanás L, Sauer H, Gaser C. Brain structural correlates of schizotypy and psychosis proneness in a non-clinical healthy volunteer sample. Schizophr Res 2015; 168:37-43. [PMID: 26164819 DOI: 10.1016/j.schres.2015.06.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 06/02/2015] [Accepted: 06/21/2015] [Indexed: 01/10/2023]
Abstract
Schizotypal traits are phenotypic risk factors for schizophrenia, associated with biological changes across a putative schizophrenia spectrum. In this study, we tested the hypothesis that brain structural changes in key brain areas relevant to this spectrum (esp. medial and lateral prefrontal cortex) would vary across different degrees of schizotypal trait expression and/or phenotypic markers of psychosis proneness in healthy non-clinical volunteers. We analysed high-resolution 3Tesla magnetic resonance images (MRI) of 59 healthy volunteers using voxel-based morphometry (VBM), correlating grey matter values to the positive and negative symptom factors of the schizotypal personality questionnaire (SPQ, German version) and a measure of psychosis proneness (community assessment of psychic experiences, CAPE). We found positive correlations between positive SPQ dimension and bilateral inferior and right superior frontal cortices, and positive CAPE dimension and left inferior frontal cortex, as well as CAPE negative dimension and right supplementary motor area (SMA) and left inferior parietal cortex. However, only the positive correlation of the right precuneus with negative schizotypy scores was significant after FWE correction for multiple comparisons. Our findings confirm an effect of schizotypal traits and psychosis proneness on brain structure in healthy subjects, providing further support to a biological continuum model.
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Affiliation(s)
- Igor Nenadic
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany.
| | - Carsten Lorenz
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Maren Dietzek
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Nils Schönfeld
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Lourdes Fañanás
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Spain; Centro de Investigaciones Biomédicas en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Heinrich Sauer
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany; Department of Neurology, Jena University Hospital, 07743 Jena, Germany
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Revisiting visual dysfunctions in schizophrenia from the retina to the cortical cells: A manifestation of defective neurodevelopment. Prog Neuropsychopharmacol Biol Psychiatry 2015; 62:29-34. [PMID: 25934388 DOI: 10.1016/j.pnpbp.2015.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/11/2015] [Accepted: 04/22/2015] [Indexed: 01/08/2023]
Abstract
This review highlights morphological and functional anomalies found along the entire visual pathway in schizophrenia, from the retina to the cortex. Based on the evidence of widespread anatomical and functional visual abnormalities, we posited that a neurodevelopmental anomaly occurring early in life was likely to explain those. Incidentally, support to the neurodevelopmental theory of schizophrenia is strongly emerging from many neurobiological domains. In vertebrates, the first visual structures migrate toward the orbit position at the end of the fourth week of gestation. A neurodevelopmental defect around that time on these embryonic structures could account for the visual anomalies in schizophrenia. Retinol activity might be involved in the process. Future research in schizophrenia should focus on early visual testing, on trials combining multiple visual anomaly assessments and a closer look to retinol activity during the pregnancy.
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12
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Lener MS, Wong E, Tang CY, Byne W, Goldstein KE, Blair NJ, Haznedar MM, New AS, Chemerinski E, Chu KW, Rimsky LS, Siever LJ, Koenigsberg HW, Hazlett EA. White matter abnormalities in schizophrenia and schizotypal personality disorder. Schizophr Bull 2015; 41:300-10. [PMID: 24962608 PMCID: PMC4266294 DOI: 10.1093/schbul/sbu093] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Prior diffusion tensor imaging (DTI) studies examining schizotypal personality disorder (SPD) and schizophrenia, separately have shown that compared with healthy controls (HCs), patients show frontotemporal white matter (WM) abnormalities. This is the first DTI study to directly compare WM tract coherence with tractography and fractional anisotropy (FA) across the schizophrenia spectrum in a large sample of demographically matched HCs (n = 55), medication-naive SPD patients (n = 49), and unmedicated/never-medicated schizophrenia patients (n = 22) to determine whether (a) frontal-striatal-temporal WM tract abnormalities in schizophrenia are similar to, or distinct from those observed in SPD; and (b) WM tract abnormalities are associated with clinical symptom severity indicating a common underlying pathology across the spectrum. Compared with both the HC and SPD groups, schizophrenia patients showed WM abnormalities, as indexed by lower FA in the temporal lobe (inferior longitudinal fasciculus) and cingulum regions. SPD patients showed lower FA in the corpus callosum genu compared with the HC group, but this regional abnormality was more widespread in schizophrenia patients. Across the schizophrenia spectrum, greater WM disruptions were associated with greater symptom severity. Overall, frontal-striatal-temporal WM dysconnectivity is attenuated in SPD compared with schizophrenia patients and may mitigate the emergence of psychosis.
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Affiliation(s)
- Marc S. Lener
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Edmund Wong
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Cheuk Y. Tang
- Translational and Molecular Imaging Institute, Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - William Byne
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peters Veterans Affairs Medical Center, Bronx, NY;,Department of Outpatient Psychiatry, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Kim E. Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nicholas J. Blair
- Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peters Veterans Affairs Medical Center, Bronx, NY;,Research and Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - M. Mehmet Haznedar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Department of Outpatient Psychiatry, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Antonia S. New
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Eran Chemerinski
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Department of Outpatient Psychiatry, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - King-Wai Chu
- Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peters Veterans Affairs Medical Center, Bronx, NY;,Research and Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Liza S. Rimsky
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Larry J. Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peters Veterans Affairs Medical Center, Bronx, NY;,Department of Outpatient Psychiatry, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Harold W. Koenigsberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Department of Outpatient Psychiatry, James J. Peters Veterans Affairs Medical Center, Bronx, NY
| | - Erin A. Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peters Veterans Affairs Medical Center, Bronx, NY;,Research and Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY,*To whom correspondence should be addressed; Mental Illness Research, Education, and Clinical Center, James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 6A-44, Bronx, NY, US; tel: 718-584-9000 x3701, fax: 718-364-3576, e-mail:
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13
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Hazlett EA, Lamade RV, Graff FS, McClure MM, Kolaitis JC, Goldstein KE, Siever LJ, Godbold JH, Moshier E. Visual-spatial working memory performance and temporal gray matter volume predict schizotypal personality disorder group membership. Schizophr Res 2014; 152:350-7. [PMID: 24398009 DOI: 10.1016/j.schres.2013.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/27/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prior work shows individuals with schizotypal personality disorder (SPD) evince temporal lobe volume abnormalities similar to schizophrenia but sparing of prefrontal cortex, which may mitigate psychosis and the severe neurocognitive impairments observed in schizophrenia. This study examined the extent to which frontal-temporal gray matter volume and neurocognitive performance predict: (1) SPD group membership in a demographically-balanced sample of 51 patients and 37 healthy controls; and (2) symptom severity in SPD. METHODS Dimensional gray-matter volume (left frontal-temporal regions (Brodmann area (BA) 10, 21, 22)) and neurocognitive performance on key memory tasks (California Verbal Learning Test (CVLT), Dot Test, Paced Auditory Serial Addition Test (PASAT)), all salient to schizophrenia-spectrum disorders were examined in a multi-variable model. RESULTS Middle temporal gyrus (BA21) volume and spatial-working memory (Dot Test) performance were significant predictors of SPD group membership likelihood, with poorer working-memory performance indicating increased probability of SPD membership. Combining across regional volumes or cognitive measures resulted in fair-to-good discrimination of group membership, but including neurocognitive and non-collinear regional volume measures together resulted in a receiver-operating-characteristic (ROC) curve with improved diagnostic discrimination. Larger BA10 volume in dorsolateral prefrontal cortex (DLPFC) significantly predicted less symptom severity in SPD. CONCLUSIONS These findings suggest that temporal lobe volume and spatial-working memory performance are promising biological/phenotype markers for likelihood of SPD classification, while greater DLPFC volume may serve as a protective factor.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States; Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States.
| | - Raina V Lamade
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Fiona S Graff
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Margaret M McClure
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Jeanine C Kolaitis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States
| | - Kim E Goldstein
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Outpatient Psychiatry, James J. Peter Veterans Affairs Medical Center, Psychiatry, Bronx, NY, United States; Mental Illness Research, Education, and Clinical Center (MIRECC VISN 3), James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - James H Godbold
- Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Erin Moshier
- Department of Biostatistics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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14
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Vu MAT, Thermenos HW, Terry DP, Wolfe DJ, Voglmaier MM, Niznikiewicz MA, McCarley RW, Seidman LJ, Dickey CC. Working memory in schizotypal personality disorder: fMRI activation and deactivation differences. Schizophr Res 2013; 151:113-23. [PMID: 24161536 DOI: 10.1016/j.schres.2013.09.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/19/2013] [Accepted: 09/16/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Schizotypal personality disorder (SPD) is considered a schizophrenia spectrum disorder, sharing with schizophrenia cognitive, neuropsychological, epidemiological, and biological characteristics. Working memory may be one area of shared deficit, although to date, this is only the second study to investigate working memory in SPD using fMRI. METHODS In a block-design fMRI study, fifteen antipsychotic-naïve SPD and sixteen healthy control subjects performed blocks of a 2back visual working memory task and 0back continuous performance task while undergoing whole-brain fMRI at 3T. Whole-brain analyses were performed for the 0back>rest (fixation baseline) and the 2back>0back contrasts (isolating the working memory component from the visual perception and attention component). Parameter estimates were extracted to determine whether observed differences were due to task-induced activation and/or deactivation. RESULTS Activation differences emerged between the two groups, without differences in task performance. In the 0back task, SPD showed decreased task-induced activation of the left postcentral gyrus. In the 2back>0back contrast, HC showed greater task-induced activation of the left posterior cingulate gyrus, superior temporal gyrus, insula, and middle frontal gyrus. These differences were due to SPD subjects' decreased task-induced activation in the left posterior cingulate gyrus, and task-induced deactivation in the remaining regions. CONCLUSIONS These findings suggest that compared to HC subjects, individuals with SPD may achieve comparable working memory performance. However, differences emerge at the level of functional neural activation, attributable to different task-induced activation and deactivation patterns. Such differential recruitment of neural resources may be beneficial, contributing to SPD subjects' ability to perform these tasks comparably to HC subjects.
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Affiliation(s)
- Mai-Anh T Vu
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Abstract
Early phenomenological descriptions of schizophrenia have acknowledged the existence of milder schizophrenia spectrum disorders characterized by the presence of attenuated symptoms typically present in chronic schizophrenia. The investigation of the schizophrenia spectrum disorders offers an opportunity to elucidate the pathophysiological mechanisms giving rise to schizophrenia. Differences and similarities between subjects with schizotypal personality disorder (SPD), the prototypical schizophrenia personality disorder, and chronic schizophrenia have been investigated with genetic, neurochemical, imaging, and pharmacological techniques. Patients with SPD and the more severely ill patients with chronic schizophrenia share cognitive, social, and attentional deficits hypothesized to result from common neurodevelopmentally based cortical temporal and prefrontal pathology. However, these deficits are milder in SPD patients due to their capacity to recruit other related brain regions to compensate for dysfunctional areas. Individuals with SPD are also less vulnerable to psychosis due to the presence of protective factors mitigating subcortical DA hyperactivity. Given the documented close relationship to other schizophrenic disorders, SPD will be included in the psychosis section of DSM-5 as a schizophrenia spectrum disorder as well as in the personality disorder section.
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Fervaha G, Remington G. Neuroimaging findings in schizotypal personality disorder: a systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43:96-107. [PMID: 23220094 DOI: 10.1016/j.pnpbp.2012.11.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/10/2012] [Accepted: 11/28/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizotypal personality disorder is the prototypical schizophrenia-spectrum condition, sharing similar phenomenological, cognitive, genetic, physiological, neurochemical, neuroanatomical and neurofunctional abnormalities with schizophrenia. Investigations into SPD circumvent many confounds inherent to schizophrenia such as medication and institutionalization. Hence, SPD offers a unique vantage point from which to study schizophrenia-spectrum conditions. METHODS We systematically reviewed the neuroimaging literature in SPD to establish: (1) whether there are concordant findings in SPD and schizophrenia, possibly reflective of core pathology between the two conditions and (2) whether there are discordant findings in SPD and schizophrenia, possibly reflecting protective factors in the former. The findings are synthesized across structural and functional neuroimaging domains. RESULTS A total of 54 studies were identified. Medial temporal lobe structures seem to be compromised in both SPD and schizophrenia. In schizophrenia prefrontal structures are further compromised, whereas in SPD these seem to be larger-than-normal, possibly reflecting a compensatory mechanism. Additional pathology is discussed, including evidence of aberrant subcortical dopaminergic functioning. CONCLUSIONS SPD is a schizophrenia-spectrum condition that shares pathology with schizophrenia, but is distinct in showing unique neural findings. Future studies are needed to confirm and localize regions of common and disparate pathology between SPD and schizophrenia.
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Affiliation(s)
- Gagan Fervaha
- Schizophrenia Program, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
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17
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Chemerinski E, Byne W, Kolaitis JC, Glanton CF, Canfield EL, Newmark RE, Haznedar MM, Novakovic V, Chu KW, Siever LJ, Hazlett EA. Larger putamen size in antipsychotic-naïve individuals with schizotypal personality disorder. Schizophr Res 2013. [PMID: 23187070 PMCID: PMC3634353 DOI: 10.1016/j.schres.2012.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To (a) compare the size of the dorsal and ventral striatum (caudate and putamen) in a large sample of antipsychotic-naïve individuals with schizotypal personality disorder (SPD) and healthy control participants; (b) examine symptom correlates of striatal size in SPD. METHODS The left and right caudate and putamen were hand-traced on structural MRI at five dorsal to ventral slice levels in 76 SPD and 148 healthy control participants. A Group×Region (caudate, putamen)×Slice (1-5: ventral, 2, 3, 4, dorsal)×Hemisphere (left, right) mixed-model MANOVA was conducted on size relative to whole brain. RESULTS Primary results showed that compared with the controls, the SPD group showed (a) larger bilateral putamen size overall and this enlargement was more pronounced at the most ventral and dorsal levels; in contrast, there were no between-group differences in caudate volume; (b) larger bilateral size of the striatum ventrally, averaged across the caudate and putamen. Among the SPD group, larger striatal size ventrally, particularly in the left hemisphere was associated with less severe paranoid symptoms. CONCLUSIONS Striatal size is abnormal in SPD and resembles that of patients with schizophrenia who respond well to antipsychotic treatment. The results suggest that striatal size may be an important endophenotype to consider when developing new pharmacological treatments and when studying factors mitigating psychosis.
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Affiliation(s)
- Eran Chemerinski
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States,Department of Outpatient Psychiatry, James J. Peter Veterans Affairs Medical Center, Psychiatry, Bronx, NY, United States
| | - William Byne
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States,Department of Outpatient Psychiatry, James J. Peter Veterans Affairs Medical Center, Psychiatry, Bronx, NY, United States,Mental Illness Research, Education, and Clinical Center, James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Jeanine C. Kolaitis
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States,Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States
| | - Cathryn F. Glanton
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States
| | - Emily L. Canfield
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States
| | - Randall E. Newmark
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States
| | - M. Mehmet Haznedar
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States,Department of Outpatient Psychiatry, James J. Peter Veterans Affairs Medical Center, Psychiatry, Bronx, NY, United States
| | - Vladan Novakovic
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States
| | - King-Wai Chu
- Mental Illness Research, Education, and Clinical Center, James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Larry J. Siever
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States,Department of Outpatient Psychiatry, James J. Peter Veterans Affairs Medical Center, Psychiatry, Bronx, NY, United States,Mental Illness Research, Education, and Clinical Center, James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States
| | - Erin A. Hazlett
- Mount Sinai School of Medicine, Department of Psychiatry, New York, NY, United States,Mental Illness Research, Education, and Clinical Center, James J. Peter Veterans Affairs Medical Center, Bronx, NY, United States,Research & Development, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States,Corresponding author at: Mental Illness Research, Education, and Clinical Center (MIRECC) VISN 3, JJP VA Medical Center, 130 West Kingsbridge Road, Rm 6A-45, Bronx, NY 10468, United States. Tel.: +1 718 584 9000x3701; fax: +1 718 364 3576. (E.A. Hazlett)
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Sinka L, Kovari E, Santos M, Herrmann FR, Gold G, Hof PR, Bouras C, Giannakopoulos P. Microvascular changes in late-life schizophrenia and mood disorders: stereological assessment of capillary diameters in anterior cingulate cortex. Neuropathol Appl Neurobiol 2012; 38:696-709. [DOI: 10.1111/j.1365-2990.2012.01263.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Hazlett EA, Collazo T, Zelmanova Y, Entis JJ, Chu KW, Goldstein KE, Roussos P, Haznedar MM, Koenigsberg HW, New AS, Buchsbaum MS, Hershowitz JP, Siever LJ, Byne W. Anterior limb of the internal capsule in schizotypal personality disorder: fiber-tract counting, volume, and anisotropy. Schizophr Res 2012; 141:119-27. [PMID: 22995934 PMCID: PMC3742803 DOI: 10.1016/j.schres.2012.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 08/17/2012] [Accepted: 08/27/2012] [Indexed: 01/16/2023]
Abstract
Mounting evidence suggests that white matter abnormalities and altered subcortical-cortical connectivity may be central to the pathology of schizophrenia (SZ). The anterior limb of the internal capsule (ALIC) is an important thalamo-frontal white-matter tract shown to have volume reductions in SZ and to a lesser degree in schizotypal personality disorder (SPD). While fractional anisotropy (FA) and connectivity abnormalities in the ALIC have been reported in SZ, they have not been examined in SPD. In the current study, magnetic resonance (MRI) and diffusion tensor imaging (DTI) were obtained in age- and sex-matched individuals with SPD (n=33) and healthy controls (HCs; n=38). The ALIC was traced bilaterally on five equally spaced dorsal-to-ventral axial slices from each participant's MRI scan and co-registered to DTI for the calculation of FA. Tractography was used to examine tracts between the ALIC and two key Brodmann areas (BAs; BA10, BA45) within the dorsolateral prefrontal cortex (DLPFC). Compared with HCs, the SPD participants exhibited (a) smaller relative volume at the mid-ventral ALIC slice level but not the other levels; (b) normal FA within the ALIC; (c) fewer relative number of tracts between the most-dorsal ALIC levels and BA10 but not BA45 and (d) fewer dorsal ALIC-DLPFC tracts were associated with greater symptom severity in SPD. In contrast to prior SZ studies that report lower FA, individuals with SPD show sparing. Our findings are consistent with a pattern of milder thalamo-frontal dysconnectivity in SPD than schizophrenia.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA.
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Kühn S, Schubert F, Gallinat J. Higher prefrontal cortical thickness in high schizotypal personality trait. J Psychiatr Res 2012; 46:960-5. [PMID: 22551659 DOI: 10.1016/j.jpsychires.2012.04.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 03/07/2012] [Accepted: 04/05/2012] [Indexed: 10/28/2022]
Abstract
A model of schizophrenia-spectrum disorders hypothesized that schizotypy shares biomarkers with schizophrenia but due to protective factors such as a greater prefrontal cortex those individuals have a reduced vulnerability to schizophrenia. In contrast to previous studies exploring volumetric brain correlates of schizotypy focussing on clinical samples or relying on between-group comparisons we measured cortical thickness and correlated it with the expression of schizotypal personality traits in a mentally healthy sample. We acquired high-resolution MRI scans from 34 subjects and used FreeSurfer to model the grey-white and pial surfaces for each individual cortex in order to compute the distance between these surfaces to obtain a measure of cortical thickness. Differences in cortical thickness were correlated with positive and negative factors of schizotypy as assessed by means of the schizotypal personality questionnaire. We found a significant positive correlation between right dorso-lateral prefrontal cortex (DLPFC) and right dorsal premotor cortex/frontal eye fields (dPMC/FEF) and the total schizotypy score, between right DLPFC and the positive factor, and between right temporo-parietal junction and the negative factor of schizotypy. The volume of thalamus was negatively correlated with schizotypy. A significant negative correlation between thalamus volume and dPMC/FEF cortical thickness was observed. One may speculate that this finding is in line with the hypothesis of a compensatory role of greater prefrontal cortex in schizotypy in healthy populations.
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Affiliation(s)
- Simone Kühn
- Charité University Medicine, St. Hedwig Krankenhaus, Clinic for Psychiatry and Psychotherapy, Große Hamburger Straße 5-11, 10115 Berlin, Germany.
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A developmental increase in allostatic load from ages 3 to 11 years is associated with increased schizotypal personality at age 23 years. Dev Psychopathol 2012; 23:1059-68. [PMID: 22018081 DOI: 10.1017/s0954579411000496] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Although allostatic load has been investigated in mood and anxiety disorders, no prior study has investigated developmental change in allostatic load as a precursor to schizotypal personality. This study employed a multilevel developmental framework to examine whether the development of increased allostatic load, as indicated by impaired sympathetic nervous system habituation from ages 3 to 11 years, predisposes to schizotypal personality at age 23 years. Electrodermal activity to six aversive tones was recorded in 995 subjects at age 3 years and again at 11 years. Habituation slopes at both ages were used to create groups who showed a developmental increase in habituation (decreased allostatic load), and those who showed a developmental decrease in habituation (increased allostatic load). Children who showed a developmental increase in allostatic load from ages 3 to 11 years had higher levels of schizotypal personality at 23 years. A breakdown of total schizotypy scores demonstrated specificity of findings to cognitive-perceptual features of schizotypy. Findings are the first to document a developmental abnormality in allostasis in relation to adult schizotypal personality. The relative failure to develop normal habituation to repeated stressors throughout childhood is hypothesized to result in an accumulation of allostatic load and consequently increased positive symptom schizotypy in adulthood.
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Herzig DA, Mohr C. Stressing schizotypy: the modulating role of stress-relieving behaviours and intellectual capacity on functional hemispheric asymmetry. Laterality 2012; 18:152-78. [PMID: 22321071 DOI: 10.1080/1357650x.2011.638638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Relative cognitive impairments are common along the schizophrenia spectrum reflecting potential psychopathological markers. Yet stress, a vulnerability marker in schizophrenia (including its spectrum), is likewise related to cognitive impairments. We investigated whether one such cognitive marker (attenuated functional hemispheric asymmetry) during stressful life periods might be linked to individuals' schizotypal features or rather to individuals' stress-related experiences and behaviours. A total of 58 students performed a left hemisphere dominant (lateralised lexical decisions) and right hemisphere dominant (sex decisions on composite faces) task. In order to account for individual differences in stress sensitivity we separated participants into groups of high or low cognitive reserve according to their average current marks. In addition, participants filled in questionnaires on schizotypy (short O-LIFE), perceived stress, stress response, and a newly adapted questionnaire that enquired about potential stress compensation behaviour (elevated substance use). The most important finding was that enhanced substance use and cognitive disorganisation contributed to a right and left hemisphere shift in language dominance, respectively. We discuss that (i) former reports on right hemisphere shifts in language dominance with positive schizotypy might be explained by an associated higher substance use and (ii) cognitive disorganisation relates to unstable cognitive functioning that depend on individuals' life circumstances, contributing to published reports on inconsistent laterality-schizotypy relationships.
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Affiliation(s)
- Daniela A Herzig
- Department of Experimental Psychology, University of Bristol, Bristol, UK.
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Neuropsychologic profile of college students with schizotypal traits. Compr Psychiatry 2011; 52:511-6. [PMID: 21185555 DOI: 10.1016/j.comppsych.2010.10.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Revised: 10/21/2010] [Accepted: 10/27/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND This study investigated the neuropsychologic functioning in nonclinical individuals with schizotypal traits using a comprehensive battery of neuropsychologic tests. METHOD We measured the neuropsychologic functioning of individuals with psychometrically defined nonclinical schizotypy (n = 28) and healthy controls (n = 31) for verbal memory (the Korean version of the California Verbal Learning Test), nonverbal memory (the Rey-Osterrieth Complex Figure Test), executive function (the Wisconsin Card Sorting Test), and attention (the d2 Test, Trail Making Test, and Controlled Oral Word Association Test). RESULTS The schizotypal trait group committed significantly more total and perseverative errors and completed fewer categories on the Wisconsin Card Sorting Test than the control group. Performance on the other neuropsychologic tests did not differ between groups. CONCLUSIONS The nonclinical individuals with schizotypal traits demonstrated executive dysfunction, showing decreased ability in conceptualization, use of cues, and mental flexibility. Furthermore, these results indicate that the cognitive deficits observed in schizophrenia are also a characteristic of nonclinical individuals with schizotypal traits.
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Horga G, Bernacer J, Dusi N, Entis J, Chu K, Hazlett EA, Mehmet Haznedar M, Kemether E, Byne W, Buchsbaum MS. Correlations between ventricular enlargement and gray and white matter volumes of cortex, thalamus, striatum, and internal capsule in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2011; 261:467-76. [PMID: 21431919 PMCID: PMC3182327 DOI: 10.1007/s00406-011-0202-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 02/15/2011] [Indexed: 11/25/2022]
Abstract
Ventricular enlargement is one of the most consistent abnormal structural brain findings in schizophrenia and has been used to infer brain shrinkage. However, whether ventricular enlargement is related to local overlying cortex and/or adjacent subcortical structures or whether it is related to brain volume change globally has not been assessed. We systematically assessed interrelations of ventricular volumes with gray and white matter volumes of 40 Brodmann areas (BAs), the thalamus and its medial dorsal nucleus and pulvinar, the internal capsule, caudate and putamen. We acquired structural MRI ( patients with schizophrenia (n = 64) and healthy controls (n = 56)) and diffusion tensor fractional anisotropy (FA) (untreated schizophrenia n = 19, controls n = 32). Volumes were assessed by manual tracing of central structures and a semi-automated parcellation of BAs. Patients with schizophrenia had increased ventricular size associated with decreased cortical gray matter volumes widely across the brain; a similar but less pronounced pattern was seen in normal controls; local correlations (e.g. temporal horn with temporal lobe volume) were not appreciably higher than non-local correlations (e.g. temporal horn with prefrontal volume). White matter regions adjacent to the ventricles similarly did not reveal strong regional relationships. FA and center of mass of the anterior limb of the internal capsule also appeared differentially influenced by ventricular volume but findings were similarly not regional. Taken together, these findings indicate that ventricular enlargement is globally interrelated with gray matter volume diminution but not directly correlated with volume loss in the immediately adjacent caudate, putamen, or internal capsule.
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Affiliation(s)
- Guillermo Horga
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
- Schizophrenia Clinic Program, Department of Psychiatry, Hospital Clínic Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Javier Bernacer
- Laboratory of Functional Neuromorphology, Clinica Universitaria, Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
| | - Nicola Dusi
- Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Policlinico Giambattista Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Jonathan Entis
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
| | - Kingwai Chu
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
| | - Erin A. Hazlett
- Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, 10468 Bronx, NY USA
| | - M. Mehmet Haznedar
- Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, 10468 Bronx, NY USA
| | - Eileen Kemether
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
| | - William Byne
- Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, 10468 Bronx, NY USA
| | - Monte S. Buchsbaum
- Departments of Psychiatry and Radiology, NeuroPET Center, University of California, 11388 Sorrento Valley Road, Suite #100, 92121 San Diego, CA USA
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Goldstein KE, Hazlett EA, Savage KR, Berlin HA, Hamilton HK, Zelmanova Y, Look AE, Koenigsberg HW, Mitsis EM, Tang CY, McNamara M, Siever LJ, Cohen BH, New AS. Dorso- and ventro-lateral prefrontal volume and spatial working memory in schizotypal personality disorder. Behav Brain Res 2010; 218:335-40. [PMID: 21115066 DOI: 10.1016/j.bbr.2010.11.042] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 11/08/2010] [Accepted: 11/22/2010] [Indexed: 11/18/2022]
Abstract
Schizotypal personality disorder (SPD) individuals and borderline personality disorder (BPD) individuals have been reported to show neuropsychological impairments and abnormalities in brain structure. However, relationships between neuropsychological function and brain structure in these groups are not well understood. This study compared visual-spatial working memory (SWM) and its associations with dorsolateral prefrontal cortex (DLPFC) and ventrolateral prefrontal cortex (VLPFC) gray matter volume in 18 unmedicated SPD patients with no BPD traits, 18 unmedicated BPD patients with no SPD traits, and 16 healthy controls (HC). Results showed impaired SWM in SPD but not BPD, compared with HC. Moreover, among the HC group, but not SPD patients, better SWM performance was associated with larger VLPFC (BA44/45) gray matter volume (Fisher's Z p-values <0.05). Findings suggest spatial working memory impairments may be a core neuropsychological deficit specific to SPD patients and highlight the role of VLPFC subcomponents in normal and dysfunctional memory performance.
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Affiliation(s)
- Kim E Goldstein
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
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Factors in sensory processing of prosody in schizotypal personality disorder: an fMRI experiment. Schizophr Res 2010; 121:75-89. [PMID: 20362418 PMCID: PMC2905482 DOI: 10.1016/j.schres.2010.03.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 03/04/2010] [Accepted: 03/09/2010] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Persons diagnosed with schizophrenia demonstrate deficits in prosody recognition. To examine prosody along the schizophrenia spectrum, antipsychotic-naïve schizotypal personality disorder (SPD) subjects and healthy control subjects were compared. It was hypothesized that SPD subjects would perform more poorly; with cognitive and demographic factors contributing to the poor performance. The superior temporal gyrus (STG) was selected as the region-of-interest (ROI) given its known abnormalities in SPD and its important role in the processing of prosody. METHODS SPD and healthy comparison (HC) subjects were matched on age, IQ, and parental social-economic status (PSES). Cognitive measures included the Speech Sound Perception Test (SSPT) to examine phonological processing (SPD=68, HC=74) and the Verbal Fluency task to examine executive functioning (SPD=129, HC=138). The main experiment was a novel fMRI task of prosody identification using semantically neutral sentences spoken with emotional prosody (SPD=16, HC=13). Finally, volumetric measurement of the superior temporal sulcus (STS), a key region for processing prosody, and partially overlapping with the STG, was performed (SPD=30, HC=30). RESULTS Phonological processing and executive functioning were both impaired in SPD subjects compared with HC subjects. Contrary to the prediction, SPD subjects, as a group, were similar to HC subjects in terms of correctly indentifying the emotion conveyed and reaction time. Within the SPD group, prosody identification accuracy was influenced by executive functioning, IQ and perhaps PSES, relationships not found with HC subjects. Phonological perception aided prosody identification in both diagnostic groups. As expected, both groups activated the STG while performing the prosody identification task. However, SPD subjects may have been less "efficient" in their recruitment of STG neurons. Finally, SPD subjects demonstrated a trend toward smaller STS volumes on the left, particularly the lower bank. CONCLUSIONS These data suggest that subtle differences between SPD and controls in phonological processing, executive functioning, IQ, and possibly PSES, contributed to difficulty in processing prosody for some SPD subjects.
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Abstract
Facial emotion recognition deficits have been widely investigated in individuals with schizophrenia; however, it remains unclear whether these deficits reflect a trait-like vulnerability to schizophrenia pathology present in individuals at risk for the disorder. Although some studies have investigated emotion recognition in this population, findings have been mixed. The current study uses a well-validated emotion recognition task, a relatively large sample, and examines the relationship between emotion recognition, symptoms, and overall life quality. Eighty-nine individuals with psychometrically defined schizotypy and 27 controls completed the Schizotypal Personality Questionnaire, Penn Emotion Recognition Test, and a brief version of Lehman's Quality of Life Interview. In addition to labeling facial emotions, participants rated the valence of faces using a Likert rating scale. Individuals with schizotypy were significantly less accurate than controls when labeling emotional faces, particularly neutral faces. Within the schizotypy sample, both disorganization symptoms and lower quality of life were associated with a bias toward perceiving facial expressions as more negative. Our results support previous research suggesting that poor emotion recognition is associated with vulnerability to psychosis. Although emotion recognition appears unrelated to symptoms, it probably operates by means of different processes in those with particular types of symptoms.
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Uranova NA, Zimina IS, Vikhreva OV, Krukov NO, Rachmanova VI, Orlovskaya DD. Ultrastructural damage of capillaries in the neocortex in schizophrenia. World J Biol Psychiatry 2010; 11:567-78. [PMID: 20109113 DOI: 10.3109/15622970903414188] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Neuroimaging studies showed lowered blood flow, glucose metabolic rates and hypoactivation of the prefrontal cortex (PFC) in patients with schizophrenia. The aim of the study was to clear up whether there are abnormalities in the microvasculature in the neocortex in schizophrenia. METHODS Capillaries were studied in PFC (BA 10) and visual cortex (VC) (BA 17) by electron microscopy and morphometry in 26 schizophrenia cases and 26 normal controls. Capillary diameter and areas of capillaries and of pericapillary astrocytic end-feet were estimated in layers I-II of the prefrontal and visual cortices. RESULTS Ultrastructural abnormalities of capillaries in schizophrenia included thickening, deformation of basal lamina, vacuolation of cytoplasm of endothelial cells, basal lamina and astrocytic end-feet, swelling of astrocytic end-feet, of pericapillary oligodendrocytes and signs of activation of microglial cells in both PFC and VC. Capillary diameter and area did not differ significantly between the groups. Area of astrocytic end-feet was significantly higher in PFC (+49%, P<0.001) and in VC (+29%, P<0.01) in schizophrenic group and in different clinical subgroups as compared to controls. CONCLUSIONS Ultrastructural abnormalities of capillaries and of pericapillary cellular environment found suggest that blood-brain barrier dysfunction might contribute to the pathogenesis of cortical lesions in schizophrenia.
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Affiliation(s)
- Natalya A Uranova
- Laboratory of Clinical Neuropathology, Mental Health Research Center, Russian Academy of Medical Sciences, Zagorodnoe shosse 2, Moscow, Russia.
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New AS, Hazlett EA, Newmark RE, Zhang J, Triebwasser J, Meyerson D, Lazarus S, Trisdorfer R, Goldstein KE, Goodman M, Koenigsberg HW, Flory JD, Siever LJ, Buchsbaum MS. Laboratory induced aggression: a positron emission tomography study of aggressive individuals with borderline personality disorder. Biol Psychiatry 2009; 66:1107-14. [PMID: 19748078 PMCID: PMC2788117 DOI: 10.1016/j.biopsych.2009.07.015] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 07/10/2009] [Accepted: 07/10/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is often associated with symptoms of impulsive aggression, which poses a threat to patients themselves and to others. Preclinical studies show that orbital frontal cortex (OFC) plays a role in regulating impulsive aggression. Prior work has found OFC dysfunction in BPD. METHODS We employed a task to provoke aggressive behavior, the Point Subtraction Aggression Paradigm (PSAP), which has never previously been used during functional brain imaging. Thirty-eight BPD patients with intermittent explosive disorder (BPD-IED) and 36 age-matched healthy control subjects (HCs) received (18)fluoro-deoxyglucose positron emission tomography ((18)FDG-PET) on two occasions with a provocation and nonprovocation version of the PSAP. Mean relative glucose metabolism was measured throughout the cortex, and difference scores (provoked - nonprovoked) were calculated. A whole brain exploratory analysis for the double difference of BPD-IED - HC for provoked - nonprovoked was also conducted. RESULTS BPD-IED patients were significantly more aggressive than HCs on the PSAP. BPD-IED patients also increased relative glucose metabolic rate (rGMR) in OFC and amygdala when provoked, while HCs decreased rGMR in these areas. However, HCs increased rGMR in anterior, medial, and dorsolateral prefrontal regions during provocation more than BPD-IED patients. CONCLUSIONS Patients responded aggressively and showed heightened rGMR in emotional brain areas, including amygdala and OFC, in response to provocation but not in more dorsal brain regions associated with cognitive control of aggression. In contrast, HCs increased rGMR in dorsal regions of PFC during aggression provocation, brain regions involved in top-down cognitive control of aggression, and, more broadly, of emotion.
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Affiliation(s)
- Antonia S. New
- James J. Peters Veterans Affairs Medical Center, Bronx, NY, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Erin A. Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | | | - Jane Zhang
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Joseph Triebwasser
- James J. Peters Veterans Affairs Medical Center, Bronx, NY, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - David Meyerson
- Department of Psychology, DePaul University, Chicago, IL
| | - Sophie Lazarus
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Roanna Trisdorfer
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Kim E. Goldstein
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Marianne Goodman
- James J. Peters Veterans Affairs Medical Center, Bronx, NY, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Harold W. Koenigsberg
- James J. Peters Veterans Affairs Medical Center, Bronx, NY, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Janine D. Flory
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, Department of Psychology, Queens College, City University of New York, New York, NY
| | - Larry J. Siever
- James J. Peters Veterans Affairs Medical Center, Bronx, NY, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
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Buchsbaum MS, Haznedar M, Newmark RE, Chu KW, Dusi N, Entis JJ, Goldstein KE, Goodman CR, Gupta A, Hazlett E, Iannuzzi J, Torosjan Y, Zhang J, Wolkin A. FDG-PET and MRI imaging of the effects of sertindole and haloperidol in the prefrontal lobe in schizophrenia. Schizophr Res 2009; 114:161-71. [PMID: 19695836 DOI: 10.1016/j.schres.2009.07.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 07/18/2009] [Accepted: 07/20/2009] [Indexed: 11/30/2022]
Abstract
Sertindole, a 2nd generation antipsychotic with low movement disorder side effects, was compared with haloperidol in a 6-week crossover study. Fifteen patients with schizophrenia (mean age=42.6, range=22-59, 11 men and 4 women) received sertindole (12-24 mg) or haloperidol (4-16 mg) for 6 weeks and then received a FDG-PET scan and an anatomical MRI. Patients were then crossed to the other treatment and received a second set of scans at week 12. Dose was adjusted by a physician blind to the medication type. Brodmann areas were identified stereotaxically using individual MRI templates applied to the coregistered FDG-PET image. Sertindole administration was associated with higher dorsolateral prefrontal cortex metabolic rates than haloperidol and lower orbitofrontal metabolic rates than haloperidol. This effect was greatest for gray matter of the dorsolateral Brodmann areas 8, 9, 10, 44, 45, and 46. Patients were further contrasted with an approximately age and sex-matched group of 33 unmedicated patients with schizophrenia and with a group of 55 normal volunteers. Sertindole administration was associated with greater change toward normal values and away from the values found in the unmedicated comparison group for dorsolateral prefrontal cortex gray matter and white matter underlying medial prefrontal and cingulate cortex. These results are consistent with the low motor side-effect profile of sertindole, greater improvement on prefrontal cognitive tasks with sertindole than haloperidol, and with the tendency of 2nd generation antipsychotic drugs to have greater frontal activation than haloperidol.
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Goldstein KE, Hazlett EA, New AS, Haznedar MM, Newmark RE, Zelmanova Y, Passarelli V, Weinstein SR, Canfield EL, Meyerson DA, Tang CY, Buchsbaum MS, Siever LJ. Smaller superior temporal gyrus volume specificity in schizotypal personality disorder. Schizophr Res 2009; 112:14-23. [PMID: 19473820 PMCID: PMC2782902 DOI: 10.1016/j.schres.2009.04.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 04/21/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Superior temporal gyrus (STG/BA22) volume is reduced in schizophrenia and to a milder degree in schizotypal personality disorder (SPD), representing a less severe disorder in the schizophrenia spectrum. SPD and Borderline personality disorder (BPD) are severe personality disorders characterized by social and cognitive dysfunction. However, while SPD is characterized by social withdrawal/anhedonia, BPD is marked by hyper-reactivity to interpersonal stimuli and hyper-emotionality. This is the first morphometric study to directly compare SPD and BPD patients in temporal lobe volume. METHODS We compared three age-, sex-, and education-matched groups: 27 unmedicated SPD individuals with no BPD traits, 52 unmedicated BPD individuals with no SPD traits, and 45 healthy controls. We examined gray matter volume of frontal and temporal lobe Brodmann areas (BAs), and dorsal/ventral amygdala from 3-T magnetic resonance imaging. RESULTS In the STG, an auditory association area reported to be dysfunctional in SPD and BPD, the SPD patients had significantly smaller volume than healthy controls and BPD patients. No group differences were found between BPD patients and controls. Smaller BA22 volume was associated with greater symptom severity in SPD patients. Reduced STG volume may be an important endophenotype for schizophrenia-spectrum disorders. SPD is distinct from BPD in terms of STG volume abnormalities which may reflect different underlying pathophysiological mechanisms and could help discriminate between them.
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Affiliation(s)
- Kim E. Goldstein
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Erin A. Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA,Erin A. Hazlett, Ph.D., Department of Psychiatry, Box 1505, Mount Sinal School of Medicine, NY, NY 10029.
| | - Antonia S. New
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC)
| | - M. Mehmet Haznedar
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Randall E. Newmark
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Yuliya Zelmanova
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Vincent Passarelli
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Shauna R. Weinstein
- Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC)
| | - Emily L. Canfield
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - David A. Meyerson
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
| | - Cheuk Y. Tang
- Department of Radiology, Mount Sinai School of Medicine, New York, NY, USA
| | - Monte S. Buchsbaum
- Departments of Psychiatry and Neurology, University of California, San Diego
| | - Larry J. Siever
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC)
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John JP, Burgess PW, Yashavantha BS, Shakeel MK, Halahalli HN, Jain S. Differential relationship of frontal pole and whole brain volumetric measures with age in neuroleptic-naïve schizophrenia and healthy subjects. Schizophr Res 2009; 109:148-58. [PMID: 19185466 DOI: 10.1016/j.schres.2008.12.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 11/28/2008] [Accepted: 12/06/2008] [Indexed: 01/24/2023]
Abstract
Brodmann's area (BA) 10, which occupies the frontal pole (FP) of the human brain, has been proven to play a central role in the executive control of cognitive operations. Previous in vivo morphometric studies of the FP have been limited by the lack of an accepted boundary of its posterior limit. We studied the FP gray matter volume in 23 healthy subjects who were age-, sex-, and education-matched to 23 neuroleptic-naïve recent-onset schizophrenia subjects in the age span 20-40 years, using a cytoarchitectonically and functionally valid landmark-based definition of its posterior boundary that we proposed recently (John, J.P., Yashavantha, B.S., Gado, M., Veena, R., Jain, S., Ravishankar, S., Csernansky, J.G., 2007. A proposal for MRI-based parcellation of the frontal pole. Brain Struct. Funct. 212, 245-253. 2007). Additionally, we examined the relationship between FP volume and age in both healthy and schizophrenia subjects to examine evidence for a possible differential relationship between these variables across the samples. A major finding of the study was the absence of a group-level difference in frontal pole gray volumes between the healthy and schizophrenia participants. However, a more complex finding emerged in relation to age effects. The healthy participants showed an inverse relationship of FP gray volume with age, even after taking total brain volume differences into account. But this age effect was completely absent in the schizophrenia group. Moreover, all the volumetric measures in schizophrenia subjects showed substantially higher range, variance, skewness and kurtosis when compared to those of healthy subjects. These findings have implications in understanding the possible role of FP in the pathophysiology of schizophrenia.
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Affiliation(s)
- John P John
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
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Effects of sex and normal aging on regional brain activation during verbal memory performance. Neurobiol Aging 2008; 31:826-38. [PMID: 19027195 DOI: 10.1016/j.neurobiolaging.2008.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 09/09/2008] [Accepted: 10/06/2008] [Indexed: 11/20/2022]
Abstract
This study examined the main and interactive effects of age and sex on relative glucose metabolic rate (rGMR) within gray matter of 39 cortical Brodmann areas (BAs) and the cingulate gyrus using (18)FDG-PET during a verbal memory task in 70 healthy normal adults, aged 20-87 years. Women showed significantly greater age-related rGMR decline in left cingulate gyrus than men (BAs 25, 24, 23, 31, 29). Both groups showed a decline in the anterior cingulate--a neuroanatomical structure that mediates effective cognitive-emotional interactions (BAs 32, 24, 25), while the other frontal regions did not show substantial decline. No sex differences in rGMR were identified within temporal, parietal and occipital lobes. Sex differences were observed for rGMR within subcomponents of the cingulate gyrus with men higher in BA25 and BA29, but lower in BA24 and BA 23 compared to women. For men, better memory performance was associated with greater rGMR in BA24, whereas in women better performance was associated with orbitofrontal-BA12. These results suggest that both age-related metabolic decline and sex differences within frontal regions are more marked in medial frontal and cingulate areas, consistent with some age-related patterns of affective and cognitive change.
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Hazlett EA, Buchsbaum MS, Zhang J, Newmark RE, Glanton CF, Zelmanova Y, Haznedar MM, Chu KW, Nenadic I, Kemether EM, Tang CY, New AS, Siever LJ. Frontal-striatal-thalamic mediodorsal nucleus dysfunction in schizophrenia-spectrum patients during sensorimotor gating. Neuroimage 2008; 42:1164-77. [PMID: 18588988 PMCID: PMC2548278 DOI: 10.1016/j.neuroimage.2008.05.039] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Revised: 05/15/2008] [Accepted: 05/19/2008] [Indexed: 10/22/2022] Open
Abstract
Prepulse inhibition (PPI) refers to a reduction in the amplitude of the startle eyeblink reflex to a strong sensory stimulus, the pulse, when it is preceded shortly by a weak stimulus, the prepulse. PPI is a measure of sensorimotor gating which serves to prevent the interruption of early attentional processing and it is impaired in schizophrenia-spectrum patients. In healthy individuals, PPI is more robust when attending to than ignoring a prepulse. Animal and human work demonstrates that frontal-striatal-thalamic (FST) circuitry modulates PPI. This study used functional magnetic resonance imaging (fMRI) to investigate FST circuitry during an attention-to-prepulse paradigm in 26 unmedicated schizophrenia-spectrum patients (13 schizotypal personality disorder (SPD), 13 schizophrenia) and 13 healthy controls. During 3T-fMRI acquisition and separately measured psychophysiological assessment of PPI, participants heard an intermixed series of high- and low-pitched tones serving as prepulses to an acoustic-startle stimulus. Event-related BOLD response amplitude curves in FST regions traced on co-registered anatomical MRI were examined. Controls showed greater activation during attended than ignored PPI conditions in all FST regions-dorsolateral prefrontal cortex (Brodmann areas 46, 9), striatum (caudate, putamen), and the thalamic mediodorsal nucleus. In contrast, schizophrenia patients failed to show differential BOLD responses in FST circuitry during attended and ignored prepulses, whereas SPD patients showed greater-than-normal activation during ignored prepulses. Among the three diagnostic groups, lower left caudate BOLD activation during the attended PPI condition was associated with more deficient sensorimotor gating as measured by PPI. Schizophrenia-spectrum patients exhibit inefficient utilization of FST circuitry during attentional modulation of PPI. Schizophrenia patients have reduced recruitment of FST circuitry during task-relevant stimuli, whereas SPD patients allocate excessive resources during task-irrelevant stimuli. Dysfunctional FST activation, particularly in the caudate may underlie PPI abnormalities in schizophrenia-spectrum patients.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Box 1505, Mount Sinai School of Medicine, New York, NY 10029, USA.
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New AS, Goodman M, Triebwasser J, Siever LJ. Recent advances in the biological study of personality disorders. Psychiatr Clin North Am 2008; 31:441-61, vii. [PMID: 18638645 DOI: 10.1016/j.psc.2008.03.011] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
While it is premature to provide a simple model for the vulnerability to the development of either borderline (BPD) or schizotypal (SPD) personality disorder, it is clear that these heritable disorders lend themselves to fruitful neurobiological exploration. The most promising findings in BPD suggest that a diminished top-down control of affective responses, which is likely to relate to deceased responsiveness of specific midline regions of prefrontal cortex, may underlie the affective hyperresponsiveness in this disorder. In addition, genetic and neuroendocrine and molecular neuroimaging findings point to a role for serotonin in this affective disinhibition. Clearly SPD falls within the schizophrenia spectrum, but precisely the nature of what predicts full-blown schizophrenia as opposed to the milder symptoms of SPD is not yet clear.
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Affiliation(s)
- Antonia S New
- The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1217, New York, NY 10029, USA.
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Abstract
Evidence suggests that individuals with schizophrenia demonstrate emotion-processing deficits. However, the nature and extent of emotion abnormalities in individuals considered at risk for schizophrenia have not been previously summarized. This article provides a review of the recent literature pertaining to emotion processing in 3 at-risk populations: those at familial high risk, those with schizotypal characteristics, and those in the putative prodrome to psychosis. Studies are reviewed across the components of emotion perception, experience, and expression. Further, we discuss investigations into psychophysiology, brain structure, and brain function that employ emotion probes. Review of the literature suggests that individuals at high risk demonstrate similar abnormalities to those with schizophrenia but at an attenuated level. The most robust findings in at-risk groups are in the areas of reduced emotion perception, self-reported anhedonia, and increased negative affect. We conclude with an agenda for future research.
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Affiliation(s)
- Laura K. Phillips
- Department of Psychology, Harvard University,Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center,To whom correspondence should be addressed; Harvard University, Department of Psychology, William James Hall, 33 Kirkland Street, Cambridge, MA 02138; tel: 781-718-7921, fax: 617-998-5007, e-mail:
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center,Department of Psychiatry, Massachusetts General Hospital
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Hazlett EA, Buchsbaum MS, Haznedar MM, Newmark R, Goldstein KE, Zelmanova Y, Glanton CF, Torosjan Y, New AS, Lo JN, Mitropoulou V, Siever LJ. Cortical gray and white matter volume in unmedicated schizotypal and schizophrenia patients. Schizophr Res 2008; 101:111-23. [PMID: 18272348 PMCID: PMC2672563 DOI: 10.1016/j.schres.2007.12.472] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Revised: 12/05/2007] [Accepted: 12/13/2007] [Indexed: 11/29/2022]
Abstract
Magnetic resonance imaging (MRI) studies have revealed fronto-temporal cortical gray matter volume reductions in schizophrenia. However, to date studies have not examined whether age- and sex-matched unmedicated schizotypal personality disorder (SPD) patients share some or all of the structural brain-imaging characteristics of schizophrenia patients. We examined cortical gray/white matter volumes in a large sample of unmedicated schizophrenia-spectrum patients (n=79 SPD, n=57 schizophrenia) and 148 healthy controls. MRI images were reoriented to standard position parallel to the anterior-posterior commissure line, segmented into gray and white matter tissue types, and assigned to Brodmann areas (BAs) using a postmortem-histological atlas. Group differences in regional volume of gray and white matter in the BAs were examined with MANOVA. Schizophrenia patients had significantly reduced gray matter volume widely across the cortex but more marked in frontal and temporal lobes. SPD patients had reductions in the same regions but only about half that observed in schizophrenia and sparing in key regions including BA10. In schizophrenia, greater fronto-temporal volume loss was associated with greater negative symptom severity and in SPD, greater interpersonal and cognitive impairment. Overall, our findings suggest that increased prefrontal volume in BA10 and sparing of volume loss in temporal cortex (BAs 22 and 20) may be a protective factor in SPD which reduces vulnerability to psychosis.
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Affiliation(s)
- Erin A. Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY,Corresponding author: Erin A. Hazlett, Ph.D, Department of Psychiatry, Box 1505, Mount Sinai School of Medicine, New York, NY 10029, , Phone: (212) 241-2779
| | | | | | - Randall Newmark
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Kim E. Goldstein
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Yuliya Zelmanova
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | | | - Yuliya Torosjan
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Antonia S. New
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC) and VISN 3
| | - Jennifer N. Lo
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | | | - Larry J. Siever
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY,Bronx Veterans Affairs Medical Center, NY and Mental Illness Research, Education and Clinical Center (MIRECC) and VISN 3
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Alvarez-Moya EM, Barrantes-Vidal N, Navarro JB, Subira S, Obiols JE. Exophenotypical profile of adolescents with sustained attention deficit: A 10-year follow-up study. Psychiatry Res 2007; 153:119-30. [PMID: 17662473 DOI: 10.1016/j.psychres.2006.12.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Revised: 07/26/2006] [Accepted: 12/15/2006] [Indexed: 11/23/2022]
Abstract
UNLABELLED We aimed to explore prospectively the relationship between the presence of sustained attention deficit (SAD) in early adolescence and exophenotypical measures of vulnerability to schizophrenia spectrum disorders (personality and psychosocial measures) in early adulthood. Two cohorts of community adolescents were selected in 1993 according to the presence or absence of a CPT-linked SAD. In 2003, both cohorts (Index: n=42, and CONTROL n=38) were administered the O-LIFE, the SCID-II, the DOI battery and the COPE scale, among other tests. T-tests were used to compare both cohorts. Index subjects showed a higher level of negative schizotypy, avoidant, depressive and narcissistic personality traits, as well as more asocial behavior and poorer use of coping resources than CONTROL subjects did. A SAD in early adolescence may be associated with coping and social deficits, negative schizotypy, and personality traits indicative of emotional disturbance in adulthood. Our results suggest that SAD in early adolescence might be an indicator of psychopathology in adulthood and give support to dimensional models of psychopathology.
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Affiliation(s)
- Eva M Alvarez-Moya
- Psychopathology and Neuropsychology Research Unit, Department of Health Psychology, Autonomous University of Barcelona, Bellaterra, 08193, Barcelona, Spain.
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Abstract
Schizotypal personality research holds the promise of critically important insights into the etiology and ultimate prevention of schizophrenia. This article provides a critical overview of diagnostic, developmental, demographic, psychosocial, genetic, neurodevelopmental, psychophysiological, neurochemical, neurocognitive, brain imaging, and prevention-treatment issues pertaining to this personality disorder. It is argued that genetic and early environmental influences act in concert to alter brain structure/function throughout development, resulting in disturbances to basic cognitive and affective processes that give rise to three building blocks of schizotypy-cognitive-perceptual, interpersonal, and disorganized features. Two clinical subtypes are hypothesized: (a) neurodevelopmental schizotypy, which has its roots in genetic, prenatal, and early postnatal factors, is relatively stable, has genetic affinity to schizophrenia, and may benefit preferentially from pharmacological intervention, and (b) pseudoschizotypy, which is unrelated to schizophrenia, has its roots in psychosocial adversity, shows greater symptom fluctuations, and may be more responsive to psychosocial intervention.
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Affiliation(s)
- Adrian Raine
- Department of Psychology and Neuroscience Program, University of Southern California, Los Angeles, California 90089-1061, USA.
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Buchsbaum MS, Haznedar MM, Aronowitz J, Brickman AM, Newmark RE, Bloom R, Brand J, Goldstein KE, Heath D, Starson M, Hazlett EA. FDG-PET in never-previously medicated psychotic adolescents treated with olanzapine or haloperidol. Schizophr Res 2007; 94:293-305. [PMID: 17574821 DOI: 10.1016/j.schres.2007.04.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Revised: 04/06/2007] [Accepted: 04/12/2007] [Indexed: 11/24/2022]
Abstract
We acquired Positron emission tomography with 18-F-deoxyglucose (FDG-PET) and anatomical MRI in 30 never-previously medicated psychotic adolescents (ages 13-20). (FDG-PET) was obtained at baseline and after 8-9 weeks of a randomized double-blind trial of either olanzapine or haloperidol. Neuropsychological tests of executive function were also obtained. Patients carried out the serial verbal learning task, a modification of the California Verbal Learning Test, during the uptake of the FDG. PET scans were coregistered with spoiled gradient MRI (TR=24, TE=5, flip angle 40 degrees, slice thickness 1.2 mm, field of view 230 mm) for accurate anatomical identification of regions of interest traced on the MRI. Twenty-two of the thirty patients completed the second PET and clinical evaluation. Individuals treated with olanzapine increased relative metabolic rates in the frontal lobe more than the occipital lobe while patients treated with haloperidol failed to increase frontal metabolic rates and did not show an anteroposterior gradient in medication response. Haloperidol increased striatal metabolic rate more than olanzapine. Both drugs increased thalamic metabolic rates and this increase was significantly larger in younger (age 13-15) than older (16-21) patients.
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Affiliation(s)
- Monte S Buchsbaum
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
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New AS, Hazlett EA, Buchsbaum MS, Goodman M, Mitelman SA, Newmark R, Trisdorfer R, Haznedar MM, Koenigsberg HW, Flory J, Siever LJ. Amygdala-prefrontal disconnection in borderline personality disorder. Neuropsychopharmacology 2007; 32:1629-40. [PMID: 17203018 DOI: 10.1038/sj.npp.1301283] [Citation(s) in RCA: 184] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abnormal fronto-amygdala circuitry has been implicated in impulsive aggression, a core symptom of borderline personality disorder (BPD). We examined relative glucose metabolic rate (rGMR) at rest and after m-CPP (meta-chloropiperazine) with (18)fluorodeoxyglucose (FDG) with positron emission tomography (PET) in 26 impulsive aggressive (IED)-BPD patients and 24 controls. Brain edges/amygdala were visually traced on MRI scans co-registered to PET scans; rGMR was obtained for ventral and dorsal regions of the amygdala and Brodmann areas within the prefrontal cortex (PFC). Correlation coefficients were calculated between rGMR for dorsal/ventral amygdala regions and PFC. Additionally, amygdala volumes and rGMR were examined in BPD and controls. Correlations PFC/amygdala Placebo: Controls showed significant positive correlations between right orbitofrontal (OFC) and ventral, but not dorsal, amygdala. Patients showed only weak correlations between amygdala and the anterior PFC, with no distinction between dorsal and ventral amygdala. Correlations PFC/amygdala: m-CPP response: Controls showed positive correlations between OFC and amygdala regions, whereas patients showed positive correlations between dorsolateral PFC and amygdala. Group differences between interregional correlational matrices were highly significant. Amygdala volume/metabolism: No group differences were found for amygdala volume, or metabolism in the placebo condition or in response to meta-chloropiperazine (m-CPP). We demonstrated a tight coupling of metabolic activity between right OFC and ventral amygdala in healthy subjects with dorsoventral differences in amygdala circuitry, not present in IED-BPD. We demonstrated no significant differences in amygdala volumes or metabolism between BPD patients and controls.
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Affiliation(s)
- Antonia S New
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Dickey CC, McCarley RW, Xu ML, Seidman LJ, Voglmaier MM, Niznikiewicz MA, Connor E, Shenton ME. MRI abnormalities of the hippocampus and cavum septi pellucidi in females with schizotypal personality disorder. Schizophr Res 2007; 89:49-58. [PMID: 17027236 PMCID: PMC2777663 DOI: 10.1016/j.schres.2006.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 08/14/2006] [Accepted: 08/16/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study examined MRI hippocampal volume and cavum septi pellucidi (CSP) in female subjects with schizotypal personality disorder (SPD) and comparison subjects. METHOD MRI was performed on 20 SPD and 29 comparison subjects with delineation of left and right hippocampi. Number of slices containing the CSP was counted. Subjects were given a working memory task, the Delayed Alternation task and other measures of working memory including the Wechsler Memory Test-Revised and the California Verbal Learning Test. Clinical measures were derived from the SCID-II. RESULTS SPD females evinced bilaterally smaller hippocampal volumes compared with non-psychiatric female subjects (15.1% on left, 15.7% on right). Additionally, SPD subjects showed statistically significantly more slices containing CSP, and a trend level difference when large CSP was defined as four or more slices (20% vs. 6.9%). SPD subjects demonstrated more errors, more perseverations, and a trend toward more failure to maintain set on the Delayed Alternating task, which were associated with smaller left hippocampal volumes. There was no difference between groups in logical memory, verbal learning or semantic clustering nor a significant correlation between these measures and hippocampal volumes. Clinically, in SPD subjects, right hippocampal volumes correlated negatively with odd appearance/behavior and positively with suspiciousness/paranoia, and odd speech was positively correlated with the number of slices containing a CSP in exploratory analyses. CONCLUSIONS Female SPD subjects showed bilaterally smaller hippocampal volumes and larger CSP than comparison subjects, similar to what has been shown in schizophrenia. Moreover, these abnormalities have clinically significant associations which may help to explain some of the manifestations of the disorder.
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Affiliation(s)
- Chandlee C Dickey
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA.
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Mitelman SA, Byne W, Kemether EM, Newmark RE, Hazlett EA, Haznedar MM, Buchsbaum MS. Metabolic thalamocortical correlations during a verbal learning task and their comparison with correlations among regional volumes. Brain Res 2006; 1114:125-37. [PMID: 16935269 DOI: 10.1016/j.brainres.2006.07.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2005] [Revised: 07/01/2006] [Accepted: 07/13/2006] [Indexed: 10/24/2022]
Abstract
Methods based on the analysis of metabolic and volumetric interregional correlations have been used in neuroimaging research, yet metabolic and volumetric interregional correlations for identical regions of interest have never been compared in the same group of subjects. Magnetic resonance and [18F]-fluorodeoxyglucose positron emission tomography brain images were acquired in 59 healthy subject. Correlation matrices for relative glucose metabolic rates during a verbal learning task and for relative gray matter volumes were compiled between the manually traced mediodorsal, centromedian, and pulvinar nuclei of the thalamus and 39 cortical Brodmann's areas. Metabolic correlations between the cortex and these thalamic nuclei followed the known patterns of anatomical connectivity in non-human primates. Intercorrelations of the mediodorsal nucleus were widespread with the prefrontal cortex (9 out of 10 Brodmann's areas in the left hemisphere) and temporal lobe (10 out of 11 Brodmann's areas in the left hemisphere) while the pulvinar correlated only with the parietal and occipital cortical areas. Different correlation patterns were observed for the regional gray matter volumes whereby only the pulvinar yielded extensive cortical intercorrelations, primarily with the occipital, parietal, anterior cingulate, and orbitofrontal areas in the right hemisphere. Metabolic thalamocortical correlations were much more extensive for the mediodorsal and centromedian nuclei whereas structural correlations were more extensive for the pulvinar. Therefore, metabolic and volumetric correlational methods are sensitive to different aspects of interregional relations in the brain and their comparison in the same group of subjects may render complementary and only partially overlapping connectivity information.
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Affiliation(s)
- Serge A Mitelman
- Department of Psychiatry, Neuroscience PET Laboratory, Box 1505, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.
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Mittal VA, Tessner KD, McMillan AL, Delawalla Z, Trotman HD, Walker EF. Gesture behavior in unmedicated schizotypal adolescents. JOURNAL OF ABNORMAL PSYCHOLOGY 2006; 115:351-358. [PMID: 16737399 DOI: 10.1037/0021-843x.115.2.351] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Schizotypal personality disorder is characterized by interpersonal and verbal communication deficits. Despite the important role of gesture in social communication, no published reports examine the use of gesture by individuals with SPD. In this study, raters code gesture from videotaped interviews of unmedicated adolescents with SPD, other personality disorders, or no Axis II disorder. Results indicate that SPD adolescents show significantly fewer gestures but do not differ from the other groups in overall rate of movement. The findings are discussed in light of brain regions involved in dysfunction, parallels to schizophrenia, and treatment implications.
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Abstract
The identification of endophenotypes in the personality disorders may provide a basis for the identification of underlying genotypes that influence the traits and dimensions of the personality disorders, as well as susceptibility to major psychiatric illnesses. Clinical dimensions of personality disorders that lend themselves to the study of corresponding endophenotypes include affective instability impulsiwity aggression, emotional information processing, cognitive disorganization, social deficits, and psychosis. For example, the propensity to aggression can be evaluated by psychometric measures, interview, laboratory paradigms, neurochemical imaging, and pharmacological studies. These suggest that aggression is a measurable trait that may be related to reduced serotonergic activity. Hyperresponsiveness of amygdala and other limbic structures may be related to affective instability, while structural and functional brain alterations underlie the cognitive disorganization in psychoticlike symptoms of schizotypal personality disorder. Thus, an endophenotypic approach not only provides clues to underlying candidate genes contributing to these behavioral dimensions, but may also point the way to a better understanding of pathophysiological mechanisms.
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Hazlett EA, New AS, Newmark R, Haznedar MM, Lo JN, Speiser LJ, Chen AD, Mitropoulou V, Minzenberg M, Siever LJ, Buchsbaum MS. Reduced anterior and posterior cingulate gray matter in borderline personality disorder. Biol Psychiatry 2005; 58:614-23. [PMID: 15993861 DOI: 10.1016/j.biopsych.2005.04.029] [Citation(s) in RCA: 149] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2004] [Revised: 02/16/2005] [Accepted: 04/14/2005] [Indexed: 01/18/2023]
Abstract
BACKGROUND Structural abnormalities in prefrontal and cingulate gyrus regions-important in affective processing, impulse control and cognition may contribute to the psychopathology of borderline personality disorder (BPD). Previous MRI studies examining volume have reported that compared with healthy controls, BPD patients have decreases in right anterior cingulate, no differences in dorsolateral prefrontal cortex, and mixed findings for prefrontal cortex. We extended this investigation by examining gray and white matter volume of frontal and cingulate gyrus Brodmann areas (BAs) in a large group of patients and healthy controls. METHODS MRI scans were acquired in 50 BPD patients (n = 13 with comorbid diagnosis of BPD and Schizotypal Personality Disorder (SPD) and n = 37 without SPD) and 50 healthy controls, and gray/white matter volume in cingulate gyrus and frontal lobe BAs were assessed. Normal BPD and BPD subgroup comparisons were conducted. RESULTS Compared with controls, BPD patients showed reduced gray matter volume in BA 24 and 31 of the cingulate. BPD patients without comorbid SPD had isolated gray matter volume loss in BA 24, but were spared for BA 31 in contrast to BPD patients with SPD. There were no group differences in whole cingulate or frontal lobe volume. CONCLUSIONS The finding of more pervasive cingulate shrinkage in the patients with BPD and SPD comorbidity resembles recent observations with the same methods in patients with schizophrenia. The pattern of reduced anterior and posterior cingulate gray matter volume in BPD patients, particularly those comorbid for SPD is consistent with the affective and attentional deficits observed in these personality disorders.
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Affiliation(s)
- Erin A Hazlett
- Department of Psychiatry, Mount Sinai School of Medicine, Box 1505, New York, NY 10029, USA.
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Dickey CC, McCarley RW, Niznikiewicz MA, Voglmaier MM, Seidman LJ, Kim S, Shenton ME. Clinical, cognitive, and social characteristics of a sample of neuroleptic-naive persons with schizotypal personality disorder. Schizophr Res 2005; 78:297-308. [PMID: 15985362 PMCID: PMC2766931 DOI: 10.1016/j.schres.2005.05.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2005] [Revised: 05/12/2005] [Accepted: 05/18/2005] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Schizotypal personality disorder (SPD) shares with schizophrenia many biological features, yet little is known about the clinical characteristics of persons diagnosed with this disorder. This report describes the clinical, cognitive and socio-occupational characteristics of a community sample of subjects diagnosed with SPD. METHOD Sixty-four male and 40 female neuroleptic-naive DSM-IV SPD subjects and 59 male and 51 female comparison subjects were recruited from the community for a total sample of 214 subjects. Demographic and cognitive differences between groups and, within the SPD group, the effect of gender on clinical features, such as the SPD criteria, SAPS, SANS, Schizotypal Personality Questionnaire, and co-morbidity, were examined using ANOVA and Chi-square distributions. RESULTS SPD subjects, in contrast to comparison subjects, had significantly lower socio-economic status, poorer social relationships and skills, and lower vocabulary scores. Furthermore, SPD subjects demonstrated more impairment on Vocabulary scores than on Block Design, as measured by the WAIS-R, a pattern not seen in comparison subjects. In the SPD cohort, positive symptoms predominated and nearly half were co-morbid for major depression. With respect to gender, male SPD subjects, compared with female SPD subjects, evinced significantly more negative symptoms, fewer friends, had more odd speech, and were more likely to also suffer from paranoid and narcissistic personality disorders. In contrast to male SPD subjects, female SPD subjects perceived themselves to be more disorganized. CONCLUSIONS SPD subjects, similar to schizophrenics, are impaired socially, occupationally, and cognitively, particularly in the area of verbal measures. Moreover, male SPD subjects may be more severely affected than female SPD subjects across multiple domains of functioning.
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Affiliation(s)
- Chandlee C Dickey
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Psychiatry 116A, 940 Belmont St., Brockton, MA 02401, USA.
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Soyka M, Koch W, Möller HJ, Rüther T, Tatsch K. Hypermetabolic pattern in frontal cortex and other brain regions in unmedicated schizophrenia patients. Results from a FDG-PET study. Eur Arch Psychiatry Clin Neurosci 2005; 255:308-12. [PMID: 15834758 DOI: 10.1007/s00406-005-0563-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 11/17/2004] [Indexed: 11/24/2022]
Abstract
We report results of a FDG-PET study in 10 patients with schizophrenia (6 unmedicated, 4 never medicated) and 12 healthy age-matched controls. The patients met ICD-10 and DSM-IV criteria for schizophrenia and all reported psychotic, "positive" symptoms when tested. Schizophrenic patients had higher absolute CMRGlu values in almost all quantified regions compared to normal subjects. Using the occipital cortex as the reference region patients showed a hyperfrontal metabolic pattern. Other significant regional differences were found with respect to thalamus, striatum and temporal cortex. The finding of a hyperfrontality in un- and never medicated psychotic schizophrenic patients must be discussed in the light of the psychopathological symptoms of patients when tested, a possible disruption of cortico-striato-thalamic feedback loops and recent findings of a hyperfrontality in experimentally induced psychosis (ketamine- and psilocybin-model of schizophrenia).
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Affiliation(s)
- M Soyka
- Psychiatric Hospital of the University of Munich, Nussbaumstr. 7, 80336, München, Germany.
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49
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Nakamura M, McCarley RW, Kubicki M, Dickey CC, Niznikiewicz MA, Voglmaier MM, Seidman LJ, Maier SE, Westin CF, Kikinis R, Shenton ME. Fronto-temporal disconnectivity in schizotypal personality disorder: a diffusion tensor imaging study. Biol Psychiatry 2005; 58:468-78. [PMID: 15978550 PMCID: PMC2768055 DOI: 10.1016/j.biopsych.2005.04.016] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2004] [Revised: 02/14/2005] [Accepted: 04/13/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND Using diffusion tensor imaging (DTI), we previously reported abnormalities in two critical white matter tracts in schizophrenia, the uncinate fasciculus (UF) and the cingulum bundle (CB), both related to fronto-temporal connectivity. Here, we investigate these two bundles in unmedicated subjects with schizotypal personality disorder (SPD). METHODS Fifteen male SPD subjects and 15 male control subjects were scanned with line-scan DTI. Fractional anisotropy (FA) and mean diffusivity (D(m)) were used to quantify water diffusion, and cross-sectional area was defined with a directional threshold method. Exploratory correlation analyses were evaluated with Spearman's rho, followed by post hoc hierarchical regression analyses. RESULTS We found bilaterally reduced FA in the UF of SPD subjects. For CB, there was no significant group difference for FA or D(m) measures. Additionally, in SPD, reduced FA in the right UF was correlated with clinical symptoms, including ideas of reference, suspiciousness, restricted affect, and social anxiety. In contrast, left UF area was correlated with measures of cognitive function, including general intelligence, verbal and visual memory, and executive performance. CONCLUSIONS These findings in SPD suggest altered fronto-temporal connectivity through the UF, similar to findings in schizophrenia, and intact neocortical-limbic connectivity through the CB, in marked contrast with what has been reported in schizophrenia.
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Affiliation(s)
- Motoaki Nakamura
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
| | - Robert W. McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
| | - Marek Kubicki
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Chandlee C. Dickey
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
- Departments of Psychiatry and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Margaret A. Niznikiewicz
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
| | - Martina M. Voglmaier
- Department of Psychiatry, Harvard Medical School at Cambridge Hospital, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School at Massachusetts Mental Health Center and Massachusetts General Hospital, Boston
| | - Stephan E. Maier
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Carl-Fredrik Westin
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Ron Kikinis
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Martha E. Shenton
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, and Harvard Medical School, Boston
- Surgical Planning Laboratory, Magnetic Resonance Imaging Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston
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Suzuki M, Zhou SY, Takahashi T, Hagino H, Kawasaki Y, Niu L, Matsui M, Seto H, Kurachi M. Differential contributions of prefrontal and temporolimbic pathology to mechanisms of psychosis. ACTA ACUST UNITED AC 2005; 128:2109-22. [PMID: 15930048 DOI: 10.1093/brain/awh554] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Common abnormalities within the schizophrenia spectrum may be essential for the pathogenesis of schizophrenia, but additional pathological changes may be required for the development of full-blown schizophrenia. Clarifying the neurobiological similarities and differences between established schizophrenia and a milder form of schizophrenia spectrum disorder would potentially discriminate the pathophysiological mechanisms underlying the core features of the schizophrenia spectrum from those associated with overt psychosis. High-resolution MRIs were acquired from 25 patients with schizotypal disorder, 53 patients with schizophrenia and 59 healthy volunteers matched for age, gender, handedness and parental education. Volumetric measurements of the medial temporal structures and the prefrontal cortex subcomponents were performed using consecutive 1-mm thick coronal slices. Parcellation of the prefrontal cortex into subcomponents was performed according to the intrinsic anatomical landmarks of the frontal sulci/gyri. Compared with the controls, the bilateral volumes of the amygdala and the hippocampus were reduced comparably in the schizotypal and schizophrenia patients. The parahippocampal gyrus volume did not differ significantly between diagnostic groups. Total prefrontal grey matter volumes were smaller bilaterally in the schizophrenia patients than in the controls and the schizotypal patients, whereas the schizotypal patients had larger prefrontal grey matter than the controls in the right hemisphere. In the schizophrenia patients, grey matter volumes of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral inferior frontal gyrus and bilateral straight gyrus were smaller than those in the controls. The schizophrenia patients also had reduced grey matter volumes in the right superior frontal gyrus, bilateral middle frontal gyrus and right inferior frontal gyrus relative to the schizotypal patients. Compared with the controls, the schizotypal patients had larger volumes of the bilateral middle frontal gyrus and smaller volumes of the right straight gyrus. There were no significant between-group differences in volumes of the ventral medial prefrontal cortex or the orbitofrontal cortex. These findings suggest that volume reductions in the amygdala and hippocampus are the common morphological substrates for the schizophrenia spectrum, which presumably represent the vulnerability. Additional widespread involvement of the prefrontal cortex in schizophrenia may lead to the loss of inhibitory control in other brain regions and suggests (although it is not specifically be related to) its critical role in the manifestation of overt psychosis.
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Affiliation(s)
- Michio Suzuki
- Department of Neuropsychiatry, Toyama Medical and Pharmaceutical University, Toyama 930-0194, Japan.
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