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Northoff G, Hirjak D. Integrating subjective and objective-spatiotemporal approach to psychiatric disorders. Mol Psychiatry 2023; 28:4022-4024. [PMID: 37198263 DOI: 10.1038/s41380-023-02100-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/21/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Affiliation(s)
- Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada.
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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2
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Ali DH, Elserafi DM, Soltan MAR, Eissa MF, Zein HA, Elshahawi HH. Schizophrenic patients’ cognitive functions in relation to their metabolic profile: a cross-sectional, comparative study on an Egyptian sample. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00053-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Patients with schizophrenia suffer from diffuse cognitive impairment and high prevalence of cardiovascular metabolic risks, associated with poor clinical outcomes. We aimed in this study to test the presence of cognitive impairment in a sample of patients with schizophrenia, and evaluate its possible relations to patients’ metabolic profile. We recruited forty patients diagnosed with schizophrenia and their matched controls from the inpatient departments and outpatient services from January to December 2016. Schizophrenia diagnosis was confirmed by the ICD10 criteria checklist. Symptoms profile and severity were assessed by the Positive and Negative Syndrome Scale. Cognitive profile was assessed through (1) Trail Making Test, Parts A and B and (2) Wechsler Memory Scale-Revised Visual Reproduction Test. Metabolic profile was assessed by measuring the body mass index, fasting blood glucose, and lipid profile. SPSS (V. 22.0, IBM Corp., USA, 2013) was used for data analysis.
Results
The patients group had a significantly higher means in the speed of processing, executive function, attention, and working memory scores on TMT-A (p = 0.0), TMT-B (p = 0.00), and WMS-R (p = 0.029) and significantly higher FBG levels (p = 0.00). Correlation studies showed that the increase in patients’ age, illness duration, treatments, number of hospitalizations, number of episodes and of ECT sessions received, symptoms severity, and deficits in cognitive function scores was associated with higher BMI and FBG.
Conclusions
Patients with schizophrenia have a higher prevalence of cognitive impairment and vascular risk factors than the general population. Close monitoring and early management of these risk factors can promote better cognitive abilities and overall functions.
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Rollins CPE, Garrison JR, Arribas M, Seyedsalehi A, Li Z, Chan RCK, Yang J, Wang D, Liò P, Yan C, Yi ZH, Cachia A, Upthegrove R, Deakin B, Simons JS, Murray GK, Suckling J. Evidence in cortical folding patterns for prenatal predispositions to hallucinations in schizophrenia. Transl Psychiatry 2020; 10:387. [PMID: 33159044 PMCID: PMC7648757 DOI: 10.1038/s41398-020-01075-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/30/2020] [Accepted: 10/22/2020] [Indexed: 12/26/2022] Open
Abstract
All perception is a construction of the brain from sensory input. Our first perceptions begin during gestation, making fetal brain development fundamental to how we experience a diverse world. Hallucinations are percepts without origin in physical reality that occur in health and disease. Despite longstanding research on the brain structures supporting hallucinations and on perinatal contributions to the pathophysiology of schizophrenia, what links these two distinct lines of research remains unclear. Sulcal patterns derived from structural magnetic resonance (MR) images can provide a proxy in adulthood for early brain development. We studied two independent datasets of patients with schizophrenia who underwent clinical assessment and 3T MR imaging from the United Kingdom and Shanghai, China (n = 181 combined) and 63 healthy controls from Shanghai. Participants were stratified into those with (n = 79 UK; n = 22 Shanghai) and without (n = 43 UK; n = 37 Shanghai) hallucinations from the PANSS P3 scores for hallucinatory behaviour. We quantified the length, depth, and asymmetry indices of the paracingulate and superior temporal sulci (PCS, STS), which have previously been associated with hallucinations in schizophrenia, and constructed cortical folding covariance matrices organized by large-scale functional networks. In both ethnic groups, we demonstrated a significantly shorter left PCS in patients with hallucinations compared to those without, and to healthy controls. Reduced PCS length and STS depth corresponded to focal deviations in their geometry and to significantly increased covariance within and between areas of the salience and auditory networks. The discovery of neurodevelopmental alterations contributing to hallucinations establishes testable models for these enigmatic, sometimes highly distressing, perceptions and provides mechanistic insight into the pathological consequences of prenatal origins.
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Affiliation(s)
- Colleen P. E. Rollins
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jane R. Garrison
- grid.5335.00000000121885934Department of Psychology, University of Cambridge, Cambridge, UK
| | - Maite Arribas
- grid.5335.00000000121885934Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK ,grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Aida Seyedsalehi
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Zhi Li
- grid.9227.e0000000119573309Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Raymond C. K. Chan
- grid.9227.e0000000119573309Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Junwei Yang
- grid.5335.00000000121885934Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Duo Wang
- grid.5335.00000000121885934Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Pietro Liò
- grid.5335.00000000121885934Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Chao Yan
- grid.22069.3f0000 0004 0369 6365Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Zheng-hui Yi
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Arnaud Cachia
- Université de Paris, LaPsyDÉ, CNRS, F-75005 Paris, France ,Université de Paris, IPNP, INSERM, F-75005 Paris, France
| | - Rachel Upthegrove
- grid.6572.60000 0004 1936 7486Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Bill Deakin
- grid.5379.80000000121662407Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
| | - Jon S. Simons
- grid.5335.00000000121885934Department of Psychology, University of Cambridge, Cambridge, UK
| | - Graham K. Murray
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - John Suckling
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
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4
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Kennedy NI, Lee WH, Frangou S. Efficacy of non-invasive brain stimulation on the symptom dimensions of schizophrenia: A meta-analysis of randomized controlled trials. Eur Psychiatry 2020; 49:69-77. [DOI: 10.1016/j.eurpsy.2017.12.025] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022] Open
Abstract
AbstractBackgroundTranscranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) have shown promise in the treatment of schizophrenia.ObjectiveTo quantify the efficacy of double-blind randomized controlled trials (RCT) of tDCS and rTMS for the positive and negative symptoms of schizophrenia and identify significant moderators relating to patient-related features and stimulation parameters.MethodsSystemic review and meta-analyses of the relevant literature published until February 1st, 2017 to assess treatment efficacy and quantify the contribution of potential moderator variables.ResultsWe identified 7 RCTs on tDCS (involving 105 participants) and 30 RCTs on rTMS (involving 768 participants). Compared to sham, tDCS improved all symptom dimensions but the effect reached significance for negative symptoms (Hedge’s g = −0.63, p = 0.02). Efficacy for positive but not negative symptoms was linearly associated with cumulative tDCS stimulation. Compared to sham, rTMS improved hallucinations (Hedge’s g = −0.51, p < 0.001) and negative symptoms (Hedge’s g = −0.49, p = 0.01) but was associated with modest, non-significant worsening of positive symptoms (Hedge’s g = 0.28, p = 0.13). Higher pulse frequency (>10 Hz), motor threshold intensity of 110%, left prefrontal cortical treatment site and trial duration over 3 weeks were associated with improvement in negative symptoms and worsening in positive symptoms (all p < 0.03).ConclusionsThe symptom dimensions in schizophrenia may respond differently to brain stimulation interventions in a way that may reflect the interaction between disease- and treatment-related mechanisms. Our findings underscore the need for further research into patient selection prior to treatment assignment and greater refinement of stimulation protocols.
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Palaniyappan L. Inefficient neural system stabilization: a theory of spontaneous resolutions and recurrent relapses in psychosis. J Psychiatry Neurosci 2019; 44:367-383. [PMID: 31245961 PMCID: PMC6821513 DOI: 10.1503/jpn.180038] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 02/07/2019] [Accepted: 03/05/2019] [Indexed: 12/21/2022] Open
Abstract
A striking feature of psychosis is its heterogeneity. Presentations of psychosis vary from transient symptoms with no functional consequence in the general population to a tenacious illness at the other extreme, with a wide range of variable trajectories in between. Even among patients with schizophrenia, who are diagnosed on the basis of persistent deterioration, marked variation is seen in response to treatment, frequency of relapses and degree of eventual recovery. Existing theoretical accounts of psychosis focus almost exclusively on how symptoms are initially formed, with much less emphasis on explaining their variable course. In this review, I present an account that links several existing notions of the biology of psychosis with the variant clinical trajectories. My aim is to incorporate perspectives of systems neuroscience in a staging framework to explain the individual variations in illness course that follow the onset of psychosis.
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Affiliation(s)
- Lena Palaniyappan
- From the Department of Psychiatry and Robarts Research Institute, University of Western Ontario and Lawson Health Research Institute, London, Ont., Canada
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6
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Effects and potential mechanisms of transcranial direct current stimulation (tDCS) on auditory hallucinations: A meta-analysis. Psychiatry Res 2019; 273:343-349. [PMID: 30682555 DOI: 10.1016/j.psychres.2019.01.059] [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: 10/19/2018] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 12/14/2022]
Abstract
Auditory hallucinations are the most common psychiatric symptoms of schizophrenia with high recurrence and refractoriness. Transcranial direct current stimulation (tDCS), a novel, non-invasion and affordable brain stimulation technique, has been recently applying on the schizophrenia patients to treat the auditory hallucinations. To analyze the efficacy of tDCS treatment on such symptoms and to reveal its potential working mechanisms, we carried out a structured literature search in PubMed, Embase and Cochrane Library database up to May 12, 2018. Five studies that met inclusion criteria with a total of 137 patients were included in this meta-analysis. After pooling all the data, we found that there was no significant effect between active group and sham group of tDCS (p = 0.18). When we removed one study that did not collaboratively stimulate the frontal-temporal sites, the active tDCS group marks a significant improvement of therapeutic effect compared with sham group (p = 0.007). Our findings suggested that tDCS could be a promising tool to alleviate auditory hallucinations, provided that the simulation sites and protocols are targeting at the sensorimotor frontal-parietal network.
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Kraus M, Rapisarda A, Lam M, Thong JYJ, Lee J, Subramaniam M, Collinson SL, Chong SA, Keefe RSE. Disrupted latent inhibition in individuals at ultra high-risk for developing psychosis. SCHIZOPHRENIA RESEARCH-COGNITION 2016; 6:1-8. [PMID: 28740818 PMCID: PMC5514297 DOI: 10.1016/j.scog.2016.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/22/2016] [Accepted: 07/23/2016] [Indexed: 11/29/2022]
Abstract
The addition of off-the-shelf cognitive measures to established prodromal criteria has resulted in limited improvement in the prediction of conversion to psychosis. Tests that assess cognitive processes central to schizophrenia might better identify those at highest risk. The latent inhibition paradigm assesses a subject's tendency to ignore irrelevant stimuli, a process integral to healthy perceptual and cognitive function that has been hypothesized to be a key deficit underlying the development of schizophrenia. In this study, 142 young people at ultra high-risk for developing psychosis and 105 controls were tested on a within-subject latent inhibition paradigm. Additionally, we later inquired about the strategy that each subject employed to complete the test, and further investigated the relationship between reported strategy and the extent of latent inhibition exhibited. Unlike controls, ultra high-risk subjects did not demonstrate a significant latent inhibition effect. This difference between groups became greater when controlling for strategy. The lack of latent inhibition effect in our ultra high-risk sample suggests that individuals at ultra high-risk for psychosis are impaired in their allocation of attentional resources based on past predictive value of repeated stimuli. This fundamental deficit in the allocation of attention may contribute to the broader array of cognitive impairments and clinical symptoms displayed by individuals at ultra high-risk for psychosis.
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Affiliation(s)
- Michael Kraus
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710
| | - Attilio Rapisarda
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747.,Neuroscience & Behavioral Disorders, Duke-National University of Singapore, Graduate Medical School, 8 College Road, Singapore, 169857
| | - Max Lam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747
| | - Jamie Y J Thong
- Department of Bioengineering, National University of Singapore, Block E4, #04-08, 4 Engineering Drive 3, Singapore, 117583
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747.,Department of General Psychiatry 1, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747.,Office of Clinical Sciences, Duke-National University of Singapore, Graduate Medical School, National University of Singapore, 8 College Road, Singapore, 169857
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747
| | - Simon L Collinson
- Neuroscience & Behavioral Disorders, Duke-National University of Singapore, Graduate Medical School, 8 College Road, Singapore, 169857
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747
| | - Richard S E Keefe
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 200 Trent Drive, Durham, NC, 27710.,Neuroscience & Behavioral Disorders, Duke-National University of Singapore, Graduate Medical School, 8 College Road, Singapore, 169857
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Abstract
The concept of psychosis has been shaped by traditions in the concepts of mental disorders during the last 170 years. The term "psychosis" still lacks a unified definition, but denotes a clinical construct composed of several symptoms. Delusions, hallucinations, and thought disorders are the core clinical features. The search for a common denominator of psychotic symptoms points toward combinations of neuropsychological mechanisms resulting in reality distortion. To advance the elucidation of the causes and the pathophysiology of the symptoms of psychosis, a deconstruction of the term into its component symptoms is therefore warranted. Current research is dealing with the delineation from "normality", the genetic underpinnings, and the causes and pathophysiology of the symptoms of psychosis.
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Affiliation(s)
- Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Jürgen Zielasek
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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9
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Abstract
Neuroimaging studies have generated a large body of knowledge regarding the neural correlates of schizophrenia (SZ) and bipolar disorder (BD). However, the initial goal of identifying disease-specific topographical mappings to localized brain regions or to distinct neural networks has not materialized and may be untenable. This contribution will argue that a systems neuroscience approach may prove more fruitful. The supporting evidence presented covers (a) brain structural, functional, and connectivity alterations and their implication for the clinical and cognitive manifestations of SZ and BD, (b) the prevailing system neuroscience models of the 2 disorders, and (c) key hypotheses likely to produce new insights into the mechanisms of underlying psychotic disorders.
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Affiliation(s)
- Sophia Frangou
- *To whom correspondence should be addressed; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, US; tel: 212-659-1668, fax: 212-659-8576, e-mail:
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Poletti M, Sambataro F. The development of delusion revisited: a transdiagnostic framework. Psychiatry Res 2013; 210:1245-59. [PMID: 23978732 DOI: 10.1016/j.psychres.2013.07.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 07/15/2013] [Accepted: 07/20/2013] [Indexed: 01/07/2023]
Abstract
This study proposes a transdiagnostic framework for delusion development, analysing psychiatric (schizophrenia, bipolar disorder, major depressive disorder) and neurological disorders (stroke, and neurodegenerative diseases) in which delusions are predominant. Our aim is to identify a transdiagnostic core of neural and cognitive alterations associated with delusions across distinct clinical disorders. Reviewed empirical evidence suggests delusions are associated: on the neural level with changes in the ventromedial prefrontal cortex (vmPFC) networks, and on the neuropsychological level with dysfunction in the processes (generation of affective value, the construction of internal models of the world, and the reflection about Self and/or Other's mental states) that these network mediate. The concurrent aberration of all these processes could be critical for the clinical transition to a psychotic delusional state. In particular, delusions could become clinically manifest when (1) stimuli are attributed an aberrant affective salience, that (2) is explained by the patient within distorted explanatory internal models that (3) are poorly inhibited by cognitive control systems. This framework extends the two-factor account of delusion model and suggests that common neural mechanisms for the delusions in psychiatric and in neurological disorders.
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Affiliation(s)
- Michele Poletti
- Department of Mental Health and Pathological Addiction, AUSL of Reggio Emilia, Reggio Emilia, Italy.
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Iliadou V(V, Apalla K, Kaprinis S, Nimatoudis I, Kaprinis G, Iacovides A. Is Central Auditory Processing Disorder Present in Psychosis? Am J Audiol 2013; 22:201-208. [DOI: 10.1044/1059-0889(2013/12-0073)] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Purpose
The scope of this study was to trace central auditory processing issues in patients with first-episode psychosis using a psychoacoustic test battery approach.
Method
Patients (
n
= 17) and volunteer control subjects (
n
= 17) with no personal or family history of schizophrenia were included in the study on the basis of normal hearing sensitivity. The authors implemented a central auditory processing battery consisting of monaural and binaural tests with verbal and nonverbal stimuli.
Results
Perceptual deficits in both nonverbal and verbal auditory stimuli are reported in this study, with temporal central auditory processing deficits and a mean left-ear advantage documented in the patient group.
Conclusion
This study points to the possibility of the existence of central auditory processing deficits in first-episode psychosis leading to schizophrenia. Audiologists should be aware of the psychiatric research pointing to enhanced verbal memory as a result of auditory training, linking bottom-up remediation with top-down improvement.
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Watson TL. Implications of holistic face processing in autism and schizophrenia. Front Psychol 2013; 4:414. [PMID: 23847581 PMCID: PMC3701876 DOI: 10.3389/fpsyg.2013.00414] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/19/2013] [Indexed: 01/21/2023] Open
Abstract
People with autism and schizophrenia have been shown to have a local bias in sensory processing and face recognition difficulties. A global or holistic processing strategy is known to be important when recognizing faces. Studies investigating face recognition in these populations are reviewed and show that holistic processing is employed despite lower overall performance in the tasks used. This implies that holistic processing is necessary but not sufficient for optimal face recognition and new avenues for research into face recognition based on network models of autism and schizophrenia are proposed.
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Affiliation(s)
- Tamara L. Watson
- School of Social Science and Psychology, University of Western SydneySydney, NSW, Australia
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MK-801 disrupts and nicotine augments 40 Hz auditory steady state responses in the auditory cortex of the urethane-anesthetized rat. Neuropharmacology 2013; 73:1-9. [PMID: 23688921 DOI: 10.1016/j.neuropharm.2013.05.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 03/30/2013] [Accepted: 05/06/2013] [Indexed: 01/29/2023]
Abstract
Patients with schizophrenia show marked deficits in processing sensory inputs including a reduction in the generation and synchronization of 40 Hz gamma oscillations in response to steady-state auditory stimulation. Such deficits are not readily demonstrable at other input frequencies. Acute administration of NMDA antagonists to healthy human subjects or laboratory animals is known to reproduce many sensory and cognitive deficits seen in schizophrenia patients. In the following study, we tested the hypothesis that the NMDA antagonist MK-801 would selectively disrupt steady-state gamma entrainment in the auditory cortex of urethane-anesthetized rat. Moreover, we further hypothesized that nicotinic receptor activation would alleviate this disruption. Auditory steady state responses were recorded in response to auditory stimuli delivered over a range of frequencies (10-80 Hz) and averaged over 50 trials. Evoked power was computed under baseline condition and after vehicle or MK-801 (0.03 mg/kg, iv). MK-801 produced a significant attenuation in response to 40 Hz auditory stimuli while entrainment to other frequencies was not affected. Time-frequency analysis revealed deficits in both power and phase-locking to 40 Hz. Nicotine (0.1 mg/kg, iv) administered after MK-801 reversed the attenuation of the 40 Hz response. Administered alone, nicotine augmented 40 Hz steady state power and phase-locking. Nicotine's effects were blocked by simultaneous administration of the α4β2 antagonist DHßE. Thus we report for the first time, a rodent model that mimics a core neurophysiological deficit seen in patients with schizophrenia and a pharmacological approach to alleviate it.
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Abstract
Cognitive functioning is moderately to severely impaired in patients with schizophrenia. This impairment is the prime driver of the significant disabilities in occupational, social, and economic functioning in patients with schizophrenia and an important treatment target. The profile of deficits in schizophrenia includes many of the most important aspects of human cognition: attention, memory, reasoning, and processing speed. While various efforts are under way to identify specific aspects of neurocognition that may lie closest to the neurobiological etiology and pathophysiology of the illness, and may provide relevant convergence with animal models of cognition, standard neuropsychological measures continue to demonstrate the greatest sensitivity to functionally relevant cognitive impairment.The effects of antipsychotic medications on cognition in schizophrenia and first-episode psychosis appear to be minimal. Important work on the effects of add-on pharmacologic treatments is ongoing. Very few of the studies completed to date have had sufficient statistical power to generate firm conclusions; recent studies examining novel add-on treatments have produced some encouraging findings. Cognitive remediation programs have generated considerable interest as these methods are far less costly than pharmacologic treatment and are likely to be safer. A growing consensus suggests that these interventions produce modest gains for patients with schizophrenia, but the efficacy of the various methods used has not been empirically investigated.
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