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Kim WS, Heo DW, Shen J, Tsogt U, Odkhuu S, Lee J, Kang E, Kim SW, Suk HI, Chung YC. Altered functional connectivity in psychotic disorder not otherwise specified. Psychiatry Res 2022; 317:114871. [PMID: 36209668 DOI: 10.1016/j.psychres.2022.114871] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Few studies have investigated functional connectivity (FC) in patients with psychotic disorder not otherwise specified (PNOS). We sought to identify distinct FC differentiating PNOS from schizophrenia (SZ). METHODS In total, 49 patients with PNOS, 42 with SZ, and 55 healthy controls (HC) matched for age, sex, and education underwent functional magnetic resonance imaging (fMRI) brain scans and clinical evaluation. Using six functional networks consisting of 40 regions of interest (ROIs), we conducted ROI to ROI and intra- and inter-network FC analyses using resting-state fMRI (rs-fMRI) data. Correlations of altered FC with symptomatology were explored. RESULTS We found common brain connectomics in PNOS and SZ including thalamo-cortical (especially superior temporal gyrus) hyperconnectivity, thalamo-cerebellar hypoconnectivity, and reduced within-thalamic connectivity compared to HC. Additionally, features differentiating the two patient groups included hyperconnectivity between the thalamic subregion and anterior cingulate cortex in PNOS compared to SZ and hyperconnectivity of the thalamic subregions with the posterior cingulate cortex and precentral gyrus in SZ compared to PNOS. CONCLUSIONS These findings suggest that PNOS and SZ exhibit both common and differentiating changes in neuronal connectivity. Furthermore, they may support the hypothesis that PNOS should be treated as a separate clinical syndrome with distinct neural connectomics.
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Affiliation(s)
- Woo-Sung Kim
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Da-Woon Heo
- Machine Intelligence Laboratory, Department of Artificial Intelligence, Korea University, Seoul, Korea
| | - Jie Shen
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Uyanga Tsogt
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Soyolsaikhan Odkhuu
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Jaein Lee
- Machine Intelligence Laboratory, Department of Brain & Cognitive Engineering, Korea University, Seoul, Korea
| | - Eunsong Kang
- Machine Intelligence Laboratory, Department of Brain & Cognitive Engineering, Korea University, Seoul, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Heung-Il Suk
- Machine Intelligence Laboratory, Department of Artificial Intelligence, Korea University, Seoul, Korea; Machine Intelligence Laboratory, Department of Brain & Cognitive Engineering, Korea University, Seoul, Korea.
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University, Medical School, Jeonju, Korea; Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
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2
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Pietschnig J, Gerdesmann D, Zeiler M, Voracek M. Of differing methods, disputed estimates and discordant interpretations: the meta-analytical multiverse of brain volume and IQ associations. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211621. [PMID: 35573038 PMCID: PMC9096623 DOI: 10.1098/rsos.211621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/19/2022] [Indexed: 05/03/2023]
Abstract
Brain size and IQ are positively correlated. However, multiple meta-analyses have led to considerable differences in summary effect estimations, thus failing to provide a plausible effect estimate. Here we aim at resolving this issue by providing the largest meta-analysis and systematic review so far of the brain volume and IQ association (86 studies; 454 effect sizes from k = 194 independent samples; N = 26 000+) in three cognitive ability domains (full-scale, verbal, performance IQ). By means of competing meta-analytical approaches as well as combinatorial and specification curve analyses, we show that most reasonable estimates for the brain size and IQ link yield r-values in the mid-0.20s, with the most extreme specifications yielding rs of 0.10 and 0.37. Summary effects appeared to be somewhat inflated due to selective reporting, and cross-temporally decreasing effect sizes indicated a confounding decline effect, with three quarters of the summary effect estimations according to any reasonable specification not exceeding r = 0.26, thus contrasting effect sizes were observed in some prior related, but individual, meta-analytical specifications. Brain size and IQ associations yielded r = 0.24, with the strongest effects observed for more g-loaded tests and in healthy samples that generalize across participant sex and age bands.
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Affiliation(s)
- Jakob Pietschnig
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Austria
| | - Daniel Gerdesmann
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Austria
- Department of Physics Education, Faculty of Mathematics, Natural Sciences and Technology, University of Education Freiburg, Germany
| | - Michael Zeiler
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Martin Voracek
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Austria
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3
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The role of MRI and CT of the brain in first episodes of psychosis and behavioural abnormality. Clin Radiol 2021; 76:712.e9-712.e13. [PMID: 34099260 DOI: 10.1016/j.crad.2021.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/05/2021] [Indexed: 11/20/2022]
Abstract
AIM To investigate whether computed tomography (CT)/magnetic resonance imaging (MRI) brain imaging is associated with detection of structural causes of a first episode of psychosis (FEP) or first episode of behavioural abnormality (FEB) in the paediatric population, as this has not been previously documented in the literature. MATERIALS AND METHODS Individuals with FEP/FEB but no neurological signs referred to a tertiary children's centre for cerebral MRI or CT were reviewed retrospectively. Individuals were evaluated independently with one technique (CT or MRI) only. RESULTS Thirty-four consecutive cerebral MRI and six consecutive CT examinations were identified between 2017 and 2020. No patients were identified as having an organic cause for the psychosis at MRI or CT. Four patients (9%) had incidental findings on MRI, unrelated to the psychosis, such as prominent perivascular spaces, hypoplastic transverse sinus, and sinonasal mucosal wall thickening. No abnormal findings were seen on CT. There was therefore no obvious difference between MRI and CT imaging in detecting organic disease potentially responsible for FEP. CONCLUSION Routine structural MRI or CT of the brain is unlikely to reveal disease leading to a significant change in management. MRI demonstrated only a few incidental findings, unrelated to the child's clinical history. Therefore, routine brain structural imaging of FEP/FEB in paediatric patients without focal neurology may not be routinely required. If imaging is requested, then there is no significant difference between CT and MRI in detecting clinically significant lesions.
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4
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Seiler N, Nguyen T, Yung A, O'Donoghue B. Terminology and assessment tools of psychosis: A systematic narrative review. Psychiatry Clin Neurosci 2020; 74:226-246. [PMID: 31846133 DOI: 10.1111/pcn.12966] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022]
Abstract
AIM Phenomena within the psychosis continuum that varies in frequency/duration/intensity have been increasingly identified. Different terms describe these phenomena, however there is no standardization within the terminology. This review evaluated the definitions and assessment tools of seven terms - (i) 'psychotic experiences'; (ii) 'psychotic-like experiences'; (iii) 'psychotic-like symptoms'; (iv) 'attenuated psychotic symptoms'; (v) 'prodromal psychotic symptoms'; (vi) 'psychotic symptomatology'; and (vii) 'psychotic symptoms'. METHODS EMBASE, MEDLINE, and CINAHL were searched during February-March 2019. Inclusion criteria included 1989-2019, full text, human, and English. Papers with no explicit definition or assessment tool, duplicates, conference abstracts, systematic reviews, meta-analyses, or no access were excluded. RESULTS A total of 2238 papers were identified and of these, 627 were included. Definitions and assessment tools varied, but some trends were found. Psychotic experiences and psychotic-like experiences were transient and mild, found in the general population and those at-risk. Psychotic-like symptoms were subthreshold and among at-risk populations and non-psychotic mental disorders. Attenuated psychotic symptoms were subthreshold but associated with distress, risk, and help-seeking. Prodromal psychotic symptoms referred to the prodrome of psychotic disorders. Psychotic symptomatology included delusions and hallucinations within psychotic disorders. Psychotic symptoms was the broadest term, encompassing a range of populations but most commonly involving hallucinations, delusions, thought disorder, and disorganization. DISCUSSION A model for conceptualizing the required terms is proposed and future directions needed to advance this field of research are discussed.
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Affiliation(s)
- Natalie Seiler
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Tony Nguyen
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,The University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Alison Yung
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
| | - Brian O'Donoghue
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Melbourne, Australia.,Orygen Youth Health, Parkville, Melbourne, Australia
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5
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Kawakubo H, Matsui Y, Kushima I, Ozaki N, Shimamura T. A network of networks approach for modeling interconnected brain tissue-specific networks. Bioinformatics 2019; 35:3092-3101. [PMID: 30649245 PMCID: PMC6735868 DOI: 10.1093/bioinformatics/btz032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 12/17/2018] [Accepted: 01/11/2019] [Indexed: 12/14/2022] Open
Abstract
Motivation Recent sequence-based analyses have identified a lot of gene variants that may contribute to neurogenetic disorders such as autism spectrum disorder and schizophrenia. Several state-of-the-art network-based analyses have been proposed for mechanical understanding of genetic variants in neurogenetic disorders. However, these methods were mainly designed for modeling and analyzing single networks that do not interact with or depend on other networks, and thus cannot capture the properties between interdependent systems in brain-specific tissues, circuits and regions which are connected each other and affect behavior and cognitive processes. Results We introduce a novel and efficient framework, called a ‘Network of Networks’ approach, to infer the interconnectivity structure between multiple networks where the response and the predictor variables are topological information matrices of given networks. We also propose Graph-Oriented SParsE Learning, a new sparse structural learning algorithm for network data to identify a subset of the topological information matrices of the predictors related to the response. We demonstrate on simulated data that propose Graph-Oriented SParsE Learning outperforms existing kernel-based algorithms in terms of F-measure. On real data from human brain region-specific functional networks associated with the autism risk genes, we show that the ‘Network of Networks’ model provides insights on the autism-associated interconnectivity structure between functional interaction networks and a comprehensive understanding of the genetic basis of autism across diverse regions of the brain. Availability and implementation Our software is available from https://github.com/infinite-point/GOSPEL. Supplementary information Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Hideko Kawakubo
- Division of Systems of Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusuke Matsui
- Laboratory of Intelligence Healthcare, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Itaru Kushima
- Institute for Advanced Research, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Psychotherapy for parents and children, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Teppei Shimamura
- Division of Systems of Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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6
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Kuo SS, Pogue-Geile MF. Variation in fourteen brain structure volumes in schizophrenia: A comprehensive meta-analysis of 246 studies. Neurosci Biobehav Rev 2019; 98:85-94. [PMID: 30615934 DOI: 10.1016/j.neubiorev.2018.12.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 11/21/2018] [Accepted: 12/31/2018] [Indexed: 12/24/2022]
Abstract
Despite hundreds of structural MRI studies documenting smaller brain volumes on average in schizophrenia compared to controls, little attention has been paid to group differences in the variability of brain volumes. Examination of variability may help interpret mean group differences in brain volumes and aid in better understanding the heterogeneity of schizophrenia. Variability in 246 MRI studies was meta-analyzed for 13 structures that have shown medium to large mean effect sizes (Cohen's d≥0.4): intracranial volume, total brain volume, lateral ventricles, third ventricle, total gray matter, frontal gray matter, prefrontal gray matter, temporal gray matter, superior temporal gyrus gray matter, planum temporale, hippocampus, fusiform gyrus, insula; and a control structure, caudate nucleus. No significant differences in variability in cortical/subcortical volumes were detected in schizophrenia relative to controls. In contrast, increased variability was found in schizophrenia compared to controls for intracranial and especially lateral and third ventricle volumes. These findings highlight the need for more attention to ventricles and detailed analyses of brain volume distributions to better elucidate the pathophysiology of schizophrenia.
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Affiliation(s)
- Susan S Kuo
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
| | - Michael F Pogue-Geile
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA; Department of Psychology and Department of Psychiatry, University of Pittsburgh, 4207 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
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7
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Blakey R, Ranlund S, Zartaloudi E, Cahn W, Calafato S, Colizzi M, Crespo-Facorro B, Daniel C, Díez-Revuelta Á, Di Forti M, Iyegbe C, Jablensky A, Jones R, Hall MH, Kahn R, Kalaydjieva L, Kravariti E, Lin K, McDonald C, McIntosh AM, Picchioni M, Powell J, Presman A, Rujescu D, Schulze K, Shaikh M, Thygesen JH, Toulopoulou T, Van Haren N, Van Os J, Walshe M, Murray RM, Bramon E. Associations between psychosis endophenotypes across brain functional, structural, and cognitive domains. Psychol Med 2018; 48:1325-1340. [PMID: 29094675 PMCID: PMC6516747 DOI: 10.1017/s0033291717002860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND A range of endophenotypes characterise psychosis, however there has been limited work understanding if and how they are inter-related. METHODS This multi-centre study includes 8754 participants: 2212 people with a psychotic disorder, 1487 unaffected relatives of probands, and 5055 healthy controls. We investigated cognition [digit span (N = 3127), block design (N = 5491), and the Rey Auditory Verbal Learning Test (N = 3543)], electrophysiology [P300 amplitude and latency (N = 1102)], and neuroanatomy [lateral ventricular volume (N = 1721)]. We used linear regression to assess the interrelationships between endophenotypes. RESULTS The P300 amplitude and latency were not associated (regression coef. -0.06, 95% CI -0.12 to 0.01, p = 0.060), and P300 amplitude was positively associated with block design (coef. 0.19, 95% CI 0.10-0.28, p 0.38). All the cognitive endophenotypes were associated with each other in the expected directions (all p < 0.001). Lastly, the relationships between pairs of endophenotypes were consistent in all three participant groups, differing for some of the cognitive pairings only in the strengths of the relationships. CONCLUSIONS The P300 amplitude and latency are independent endophenotypes; the former indexing spatial visualisation and working memory, and the latter is hypothesised to index basic processing speed. Individuals with psychotic illnesses, their unaffected relatives, and healthy controls all show similar patterns of associations between endophenotypes, endorsing the theory of a continuum of psychosis liability across the population.
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Affiliation(s)
- R. Blakey
- Division of Psychiatry, University College London, London, UK
| | - S. Ranlund
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Zartaloudi
- Division of Psychiatry, University College London, London, UK
| | - W. Cahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S. Calafato
- Division of Psychiatry, University College London, London, UK
| | - M. Colizzi
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - B. Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria–IDIVAL, Santander, Spain
| | - C. Daniel
- Division of Psychiatry, University College London, London, UK
| | - Á. Díez-Revuelta
- Division of Psychiatry, University College London, London, UK
- Laboratory of Cognitive and Computational Neuroscience – Centre for Biomedical Technology (CTB), Complutense University and Technical University of Madrid, Madrid, Spain
| | - M. Di Forti
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | | | - C. Iyegbe
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - A. Jablensky
- Centre for Clinical Research in Neuropsychiatry, The University of Western Australia, Perth, Western Australia, Australia
| | - R. Jones
- Division of Psychiatry, University College London, London, UK
| | - M.-H. Hall
- Psychology Research Laboratory, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - R. Kahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L. Kalaydjieva
- Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, Australia
| | - E. Kravariti
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - K. Lin
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - C. McDonald
- Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Ireland
| | - A. M. McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
| | | | - M. Picchioni
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - J. Powell
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - A. Presman
- Division of Psychiatry, University College London, London, UK
| | - D. Rujescu
- Department of Psychiatry, Ludwig-Maximilians University of Munich, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle Wittenberg, Halle, Germany
| | - K. Schulze
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - M. Shaikh
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- North East London Foundation Trust, London, UK
| | - J. H. Thygesen
- Division of Psychiatry, University College London, London, UK
| | - T. Toulopoulou
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychology, Bilkent University, Main Campus, Bilkent, Ankara, Turkey
- Department of Psychology, the University of Hong Kong, Pokfulam Rd, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, The Hong Kong Jockey Club Building for Interdisciplinary Research, Hong Kong SAR, China
| | - N. Van Haren
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J. Van Os
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, EURON, Maastricht, The Netherlands
| | - M. Walshe
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | | | - R. M. Murray
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Bramon
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
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8
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Ranlund S, Calafato S, Thygesen JH, Lin K, Cahn W, Crespo‐Facorro B, de Zwarte SM, Díez Á, Di Forti M, Iyegbe C, Jablensky A, Jones R, Hall M, Kahn R, Kalaydjieva L, Kravariti E, McDonald C, McIntosh AM, McQuillin A, Picchioni M, Prata DP, Rujescu D, Schulze K, Shaikh M, Toulopoulou T, van Haren N, van Os J, Vassos E, Walshe M, Lewis C, Murray RM, Powell J, Bramon E. A polygenic risk score analysis of psychosis endophenotypes across brain functional, structural, and cognitive domains. Am J Med Genet B Neuropsychiatr Genet 2018; 177:21-34. [PMID: 28851104 PMCID: PMC5763362 DOI: 10.1002/ajmg.b.32581] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/24/2017] [Indexed: 12/26/2022]
Abstract
This large multi-center study investigates the relationships between genetic risk for schizophrenia and bipolar disorder, and multi-modal endophenotypes for psychosis. The sample included 4,242 individuals; 1,087 patients with psychosis, 822 unaffected first-degree relatives of patients, and 2,333 controls. Endophenotypes included the P300 event-related potential (N = 515), lateral ventricular volume (N = 798), and the cognitive measures block design (N = 3,089), digit span (N = 1,437), and the Ray Auditory Verbal Learning Task (N = 2,406). Data were collected across 11 sites in Europe and Australia; all genotyping and genetic analyses were done at the same laboratory in the United Kingdom. We calculated polygenic risk scores for schizophrenia and bipolar disorder separately, and used linear regression to test whether polygenic scores influenced the endophenotypes. Results showed that higher polygenic scores for schizophrenia were associated with poorer performance on the block design task and explained 0.2% (p = 0.009) of the variance. Associations in the same direction were found for bipolar disorder scores, but this was not statistically significant at the 1% level (p = 0.02). The schizophrenia score explained 0.4% of variance in lateral ventricular volumes, the largest across all phenotypes examined, although this was not significant (p = 0.063). None of the remaining associations reached significance after correction for multiple testing (with alpha at 1%). These results indicate that common genetic variants associated with schizophrenia predict performance in spatial visualization, providing additional evidence that this measure is an endophenotype for the disorder with shared genetic risk variants. The use of endophenotypes such as this will help to characterize the effects of common genetic variation in psychosis.
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Affiliation(s)
- Siri Ranlund
- Division of PsychiatryUniversity College LondonLondonUK
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | | | | | - Kuang Lin
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Wiepke Cahn
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Benedicto Crespo‐Facorro
- CIBERSAMCentro Investigación Biomédica en Red Salud MentalMadridSpain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of MedicineUniversity of Cantabria–IDIVALSantanderSpain
| | - Sonja M.C. de Zwarte
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Álvaro Díez
- Division of PsychiatryUniversity College LondonLondonUK
- Laboratory of Cognitive and Computational Neuroscience—Centre for Biomedical Technology (CTB)Complutense University and Technical University of MadridMadridSpain
| | - Marta Di Forti
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | | | - Conrad Iyegbe
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Assen Jablensky
- Centre for Clinical Research in NeuropsychiatryThe University of Western AustraliaPerth, Western AustraliaAustralia
| | - Rebecca Jones
- Division of PsychiatryUniversity College LondonLondonUK
| | - Mei‐Hua Hall
- Psychosis Neurobiology Laboratory, Harvard Medical SchoolMcLean HospitalBelmontMassachusetts
| | - Rene Kahn
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Luba Kalaydjieva
- Harry Perkins Institute of Medical Research and Centre for Medical ResearchThe University of Western AustraliaPerthAustralia
| | - Eugenia Kravariti
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Colm McDonald
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience CentreNational University of Ireland GalwayGalwayIreland
| | - Andrew M. McIntosh
- Division of Psychiatry, University of EdinburghRoyal Edinburgh HospitalEdinburghUK
- Centre for Cognitive Ageing and Cognitive EpidemiologyUniversity of EdinburghEdinburghUK
| | | | | | - Marco Picchioni
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Diana P. Prata
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Faculdade de Medicina, Instituto de Medicina MolecularUniversidade de LisboaPortugal
| | - Dan Rujescu
- Department of PsychiatryLudwig‐Maximilians University of MunichMunichGermany
- Department of Psychiatry, Psychotherapy and PsychosomaticsUniversity of Halle WittenbergHalleGermany
| | - Katja Schulze
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Madiha Shaikh
- North East London Foundation TrustLondonUK
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Timothea Toulopoulou
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Department of Psychology, Bilkent UniversityMain CampusBilkent, AnkaraTurkey
- Department of PsychologyThe University of Hong Kong, Pokfulam RdHong Kong SARChina
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong KongThe Hong Kong Jockey Club Building for Interdisciplinary ResearchHong Kong SARChina
| | - Neeltje van Haren
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Jim van Os
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Department of Psychiatry and Psychology, Maastricht University Medical CentreEURONMaastrichtThe Netherlands
| | - Evangelos Vassos
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Muriel Walshe
- Division of PsychiatryUniversity College LondonLondonUK
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | | | - Cathryn Lewis
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Robin M. Murray
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - John Powell
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Elvira Bramon
- Division of PsychiatryUniversity College LondonLondonUK
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
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9
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Choi YK, Gardner MP, Tarazi FI. Developmental effects of antipsychotic drugs on serotonin receptor subtypes. Synapse 2017; 71:e21988. [DOI: 10.1002/syn.21988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/16/2017] [Accepted: 06/06/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Yong Kee Choi
- Department of Psychiatry and Neuroscience Program; Harvard Medical School; Boston Massachusetts
- McLean Hospital; Mailman Research Center; Belmont Massachusetts
| | - Matthew P. Gardner
- Department of Psychiatry and Neuroscience Program; Harvard Medical School; Boston Massachusetts
- McLean Hospital; Mailman Research Center; Belmont Massachusetts
| | - Frank I. Tarazi
- Department of Psychiatry and Neuroscience Program; Harvard Medical School; Boston Massachusetts
- McLean Hospital; Mailman Research Center; Belmont Massachusetts
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10
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Fusar-Poli P, Meyer-Lindenberg A. Forty years of structural imaging in psychosis: promises and truth. Acta Psychiatr Scand 2016; 134:207-24. [PMID: 27404479 DOI: 10.1111/acps.12619] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Since the first study published in the Lancet in 1976, structural neuroimaging has been used in psychosis with the promise of imminent clinical utility. The actual impact of structural neuroimaging in psychosis is still unclear. METHOD We present here a critical review of studies involving structural magnetic resonance imaging techniques in patients with psychosis published between 1976 and 2015 in selected journals of relevance for the field. For each study, we extracted summary descriptive variables. Additionally, we qualitatively described the main structural findings of each article in summary notes and we employed a biomarker rating system based on quality of evidence (scored 1-4) and effect size (scored 1-4). RESULTS Eighty studies meeting the inclusion criteria were retrieved. The number of studies increased over time, reflecting an increased structural imaging research in psychosis. However, quality of evidence was generally impaired by small samples and unclear biomarker definitions. In particular, there was little attempt of replication of previous findings. The effect sizes ranged from small to modest. No diagnostic or prognostic biomarker for clinical use was identified. CONCLUSIONS Structural neuroimaging in psychosis research has not yet delivered on the clinical applications that were envisioned.
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Affiliation(s)
- P Fusar-Poli
- Institute of Psychiatry Psychology Neuroscience, King's College London, London, UK.,OASIS Clinic, SLaM NHS Foundation Trust, London, UK
| | - A Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
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11
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Neuroimaging findings from childhood onset schizophrenia patients and their non-psychotic siblings. Schizophr Res 2016; 173:124-131. [PMID: 25819937 PMCID: PMC4583796 DOI: 10.1016/j.schres.2015.03.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 02/26/2015] [Accepted: 03/02/2015] [Indexed: 12/14/2022]
Abstract
Childhood onset schizophrenia (COS), with onset of psychosis before age 13, is a rare form of schizophrenia that represents a more severe and chronic form of the adult onset illness. In this review we examine structural and functional magnetic resonance imaging (MRI) studies of COS and non-psychotic siblings of COS patients in the context of studies of schizophrenia as a whole. Studies of COS to date reveal progressive loss of gray matter volume and cortical thinning, ventricular enlargement, progressive decline in cerebellar volume and a significant but fixed deficit in hippocampal volume. COS is also associated with a slower rate of white matter growth and disrupted local connectivity strength. Sibling studies indicate that non-psychotic siblings of COS patients share many of these brain abnormalities, including decreased cortical thickness and disrupted white matter growth, yet these abnormalities normalize with age. Cross-sectional and longitudinal neuroimaging studies remain some of the few methods for assessing human brain function and play a pivotal role in the quest for understanding the neurobiology of schizophrenia as well as other psychiatric disorders. Parallel studies in non-psychotic siblings provide a unique opportunity to understand both risk and resilience in schizophrenia.
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12
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Pietschnig J, Penke L, Wicherts JM, Zeiler M, Voracek M. Meta-analysis of associations between human brain volume and intelligence differences: How strong are they and what do they mean? Neurosci Biobehav Rev 2015; 57:411-32. [PMID: 26449760 DOI: 10.1016/j.neubiorev.2015.09.017] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 09/07/2015] [Accepted: 09/30/2015] [Indexed: 11/16/2022]
Abstract
Positive associations between human intelligence and brain size have been suspected for more than 150 years. Nowadays, modern non-invasive measures of in vivo brain volume (Magnetic Resonance Imaging) make it possible to reliably assess associations with IQ. By means of a systematic review of published studies and unpublished results obtained by personal communications with researchers, we identified 88 studies examining effect sizes of 148 healthy and clinical mixed-sex samples (>8000 individuals). Our results showed significant positive associations of brain volume and IQ (r=.24, R(2)=.06) that generalize over age (children vs. adults), IQ domain (full-scale, performance, and verbal IQ), and sex. Application of a number of methods for detection of publication bias indicates that strong and positive correlation coefficients have been reported frequently in the literature whilst small and non-significant associations appear to have been often omitted from reports. We show that the strength of the positive association of brain volume and IQ has been overestimated in the literature, but remains robust even when accounting for different types of dissemination bias, although reported effects have been declining over time. While it is tempting to interpret this association in the context of human cognitive evolution and species differences in brain size and cognitive ability, we show that it is not warranted to interpret brain size as an isomorphic proxy of human intelligence differences.
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Affiliation(s)
- Jakob Pietschnig
- Department of Applied Psychology-Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Vienna, Austria; Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria; Department of Psychology, School of Science and Technology, Middlesex University Dubai, Dubai, United Arab Emirates.
| | - Lars Penke
- Georg Elias Müller Department of Psychology, Georg August University Göttingen, Göttingen, Germany
| | - Jelte M Wicherts
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Michael Zeiler
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Martin Voracek
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria; Georg Elias Müller Department of Psychology, Georg August University Göttingen, Göttingen, Germany; Department of Psychology, University of Zürich, Zürich, Switzerland
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13
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Zhang Y, Zheng J, Fan X, Guo X, Guo W, Yang G, Chen H, Zhao J, Lv L. Dysfunctional resting-state connectivities of brain regions with structural deficits in drug-naive first-episode schizophrenia adolescents. Schizophr Res 2015; 168:353-9. [PMID: 26281967 DOI: 10.1016/j.schres.2015.07.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/05/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Individuals with adolescent-onset schizophrenia (AOS) are a subgroup of patients who present clinical symptoms between 13 and 18years of age. Little is known about neurodevelopmental abnormalities in this patient population. The present study was to examine possible resting-state dysfunctional connectivity of brain regions with altered gray matter volume in AOS. METHODS Gray matter volume was investigated by voxel-based morphometry (VBM) analysis. Resting-state functional connectivity analysis was used to examine the correlations between regions with structural deficits and the remaining regions. RESULTS Thirty-seven first-episode schizophrenia adolescents and 30 healthy controls were enrolled. Compared to the controls, the patients showed significantly decreased gray matter volumes in the right superior temporal gyrus (STG) and middle temporal gyrus (MTG) (ps<0.05). With the right STG as seed, significantly reduced connectivities were found within the frontal-temporal networks in the patient group (ps<0.05). With the right MTG as seed, the patient group showed significantly reduced connectivities in the default-mode networks and visual networks (ps<0.05). Compared to significant correlations in the controls (p=0.02), the patients had no observed correlations between functional connectivity of the right STG and gray matter volume of this region. Significant positive correlations were found between functional connectivity of the right STG with the left middle frontal gyrus and the Positive and Negative Syndrome Scale total scores (p=0.048) after controlling the confounding variables. CONCLUSIONS These findings show dysfunctional resting-state connectivities of the right STG and MTG with decreased gray matter volume in adolescents with AOS, suggesting that neurodevelopmental abnormalities may be present in AOS.
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Affiliation(s)
- Yan Zhang
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China; Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Junjie Zheng
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoduo Fan
- UMass Memorial Medical Center, University of Massachusetts Medical School, MA, USA
| | - Xiaofeng Guo
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China
| | - Wenbin Guo
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China
| | - Ge Yang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Huafu Chen
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingping Zhao
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China.
| | - Luxian Lv
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
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14
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Abstract
Childhood-onset schizophrenia is a rare pediatric onset psychiatric disorder continuous with and typically more severe than its adult counterpart. Neuroimaging research conducted on this population has revealed similarly severe neural abnormalities. When taken as a whole, neuroimaging research in this population shows generally decreased cortical gray matter coupled with white matter connectivity abnormalities, suggesting an anatomical basis for deficits in executive function. Subcortical abnormalities are pronounced in limbic structures, where volumetric deficits are likely related to social skill deficits, and cerebellar deficits that have been correlated to cognitive abnormalities. Structures relevant to motor processing also show a significant alteration, with volumetric increase in basal ganglia structures likely due to antipsychotic administration. Neuroimaging of this disorder shows an important clinical image of exaggerated cortical loss, altered white matter connectivity, and differences in structural development of subcortical areas during the course of development and provides important background to the disease state.
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15
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Yang C, Wu S, Lu W, Bai Y, Gao H. Brain differences in first-episode schizophrenia treated with quetiapine: a deformation-based morphometric study. Psychopharmacology (Berl) 2015; 232:369-77. [PMID: 25080851 DOI: 10.1007/s00213-014-3670-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 06/24/2014] [Indexed: 02/02/2023]
Abstract
RATIONALE With the development of various imaging techniques, the deformation-based morphometry (DBM) method provides an objective automatic examination of the whole brain. OBJECTIVES This study aims to assess the abnormalities in the brains of first-episode schizophrenia (FES) patients treated with quetiapine using another advanced nonrigid registration method, hierarchical attribute matching mechanism for elastic registration, through the application of DBM in the entire brain. METHODS Thirty FES patients and 30 normal controls were grouped by age and handedness and subjected to magnetic resonance imaging examination. The patients had relatively short durations of untreated psychosis (DUP; 6.4 ± 5.2 months), and only a single antipsychotic drug, quetiapine (dosage, 200 ± 75 mg), was used for treatment. Statistically significant changes in regional volume were analyzed via DBM. In addition, a voxel-wise analysis of correlations between the duration of treatment or dosage and volume was also performed. RESULTS Compared with control subjects, FES patients showed contracted regions located in Brodmann area (BA) 42 and BA 19. By contrast, expanded regions were observed in BA 38, BA 21, BA 6 and 8, and left cerebellum. A negative correlation was observed between dosage and volume in the hippocampus, while a positive correlation was found in the caudate. Meanwhile, a negative correlation was observed between duration of treatment and volume in BA 38. CONCLUSION Both regional volume reductions and increases were detected in the brains of FES patients treated with quetiapine compared with healthy control subjects. Such differences may be partially relevant to dosage and treatment duration in clinic.
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Affiliation(s)
- Chunlan Yang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100022, China
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16
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Zampieri E, Bellani M, Crespo-Facorro B, Brambilla P. Basal ganglia anatomy and schizophrenia: the role of antipsychotic treatment. Epidemiol Psychiatr Sci 2014; 23:333-6. [PMID: 25335548 PMCID: PMC7192164 DOI: 10.1017/s204579601400064x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 09/15/2014] [Accepted: 09/15/2014] [Indexed: 11/07/2022] Open
Abstract
Progressive enlargement of basal ganglia volume has been observed in schizophrenia individuals, potentially being sustained by chronic administration of antipsychotic drugs. Here we briefly summarise the state of the art of the role of antipsychotic in leading to increased basal ganglia in schizophrenia, particularly focusing on the caudate nucleus.
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Affiliation(s)
- E. Zampieri
- Department of Public Health and Community Medicine, Section of Psychiatry, Inter-University Center for Behavioural Neurosciences (ICBN), University of Verona, Verona, Italy
| | - M. Bellani
- Department of Public Health and Community Medicine, Section of Psychiatry, Inter-University Center for Behavioural Neurosciences (ICBN), University of Verona, Verona, Italy
| | - B. Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - P. Brambilla
- Department of Experimental Clinical Medicine, ICBN, University of Udine, Udine, Italy
- IRCCS ‘E. Medea’Scientific Institute, UDGEE, Udine, Italy
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17
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Cochran DM, Dvir Y, Frazier JA. "Autism-plus" spectrum disorders: intersection with psychosis and the schizophrenia spectrum. Child Adolesc Psychiatr Clin N Am 2013; 22:609-27. [PMID: 24012076 DOI: 10.1016/j.chc.2013.04.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patients are often encountered clinically who have autism spectrum disorders (ASD) and also have symptoms suggestive of a comorbid psychotic disorder. A careful assessment for the presence of comorbid disorders is important. However, the core deficits seen in ASD, in social reciprocity, communication, and restricted behaviors and interests, can be mistaken for psychosis. Also, there is a subset of patients who present with a complex neurodevelopmental disorder with impairments that cross diagnostic categories. This article reviews the connections between ASD and psychosis, and highlights the key points to consider in patients who present with these "autism-plus" disorders.
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Affiliation(s)
- David M Cochran
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Massachusetts Medical School, Biotech One, Suite 100, 365 Plantation Street, Worcester, MA 01605, USA.
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18
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Brent BK, Thermenos HW, Keshavan MS, Seidman LJ. Gray Matter Alterations in Schizophrenia High-Risk Youth and Early-Onset Schizophrenia: A Review of Structural MRI Findings. Child Adolesc Psychiatr Clin N Am 2013; 22:689-714. [PMID: 24012081 PMCID: PMC3767930 DOI: 10.1016/j.chc.2013.06.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article reviews the literature on structural magnetic resonance imaging findings in pediatric and young adult populations at clinical or genetic high-risk for schizophrenia and early-onset schizophrenia. The implications of this research are discussed for understanding the pathophysiology of schizophrenia and for early intervention strategies. The evidence linking brain structural changes in prepsychosis development and early-onset schizophrenia with disruptions of normal neurodevelopmental processes during childhood or adolescence is described. Future directions are outlined for research to address knowledge gaps regarding the neurobiological basis of brain structural abnormalities in schizophrenia and to improve the usefulness of these abnormalities for preventative interventions.
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Affiliation(s)
- Benjamin K Brent
- Harvard Medical School, Boston, MA 02115, USA; Division of Public Psychiatry, Massachusetts Mental Health Center, 75 Fenwood Road, Boston, MA 02115, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
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19
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Sepede G, De Berardis D, Campanella D, Perrucci MG, Ferretti A, Serroni N, Moschetta FS, Del Gratta C, Salerno RM, Ferro FM, Di Giannantonio M, Onofrj M, Romani GL, Gambi F. Impaired sustained attention in euthymic bipolar disorder patients and non-affected relatives: an fMRI study. Bipolar Disord 2012; 14:764-79. [PMID: 23036083 DOI: 10.1111/bdi.12007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Behavioral deficits in sustained attention have been reported during both acute and euthymic phases of type I bipolar disorder (BD-I) and also in non-affected relatives of bipolar disorder (BD) patients. In particular, selective failure in target recognition was proposed as a potential trait marker for BD, but there are few studies exploring the neural correlates. The aim of the present study was to analyze the behavioral and functional magnetic resonance imaging (fMRI) response of euthymic BD-I patients and non-affected relatives during a sustained attention task. METHODS Twenty-four euthymic BD-I patients, 22 non-affected first-degree relatives of BD-I subjects, and 24 matched controls underwent a continuous performance test (CPT) with two levels of difficulty during event-related fMRI scanning. RESULTS Both patients and relatives showed a lower accuracy in target detection when compared to controls. The fMRI data analysis revealed between-group differences in several brain regions involved in sustained attention. During error in target recognition, both patients and relatives showed a larger activation in the bilateral insula and the posterior part of the middle cingulate cortex. By contrast, during correct target response, only patients failed to activate the right insula, whereas relatives showed an increased activation of the left insula and bilateral inferior parietal lobule - limited to the higher attention load - and an augmented deactivation of the posterior cingulate/retrosplenial cortex. CONCLUSIONS A selective impairment in target recognition during a CPT was behaviorally and functionally detectable in both euthymic BD-I patients and non-affected first-degree relatives, suggesting that specific sustained attention deficits may be a potential trait marker for BD-I.
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Affiliation(s)
- Gianna Sepede
- Department of Neuroscience and Imaging, University of Chieti, Chieti, Italy.
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20
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Courvoisie H, Labellarte MJ, Riddle MA. Psychosis in children: diagnosis and treatment. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22033588 PMCID: PMC3181648 DOI: 10.31887/dcns.2001.3.2/hcourvoisie] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The diagnosis of childhood psychosis raises a host of unresolved problems, despite the Diagnostic and Statistical Manual Of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) giving identical symptoms and definitions for children, adolescents, and adults. The fantasy lives of children, and issues of developing language and cognition (including retardation), all impair diagnostic accuracy, particularly when differentiating between childhood-onset schizophrenia (COS) (≤12 years), bipolar affective disorder, major depressive disorder, and even obsessive-compulsive disorder and attention-deficit/hyperactivity disorder: the catch-all classification, psychosis not otherwise specified (PNOS), is always available for conundra that prove unsolvable. Typical if nonpathognomonic features include neurocognitive difficulties. Multiple screening instruments and specialized versions of semistructured diagnostic interviews are available. Although smooth-pursuit eye-tracking movements may prove a genetic marker for COS, etiologies are likely to be oligogenetic rather than related to a single gene. No specific biological markers or neuroimages have been identified. As such, psychoses may be indicative of a more general pattern of brain dysfunction. Drug treatments are largely based on the adult literature because of a dearth of controlled data below age 18. There are still no rigorous studies of psychosocial treatments and psychotherapy specific to childhood psychosis.
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Affiliation(s)
- H Courvoisie
- Division of Child and Adolescent Psychiatry, Johns Hopkins Medical Institutions, Baltimore, Md, USA
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21
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Juuhl-Langseth M, Rimol LM, Rasmussen IA, Thormodsen R, Holmén A, Emblem KE, Due-Tønnessen P, Rund BR, Agartz I. Comprehensive segmentation of subcortical brain volumes in early onset schizophrenia reveals limited structural abnormalities. Psychiatry Res 2012; 203:14-23. [PMID: 22917502 DOI: 10.1016/j.pscychresns.2011.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 09/09/2011] [Accepted: 10/18/2011] [Indexed: 11/20/2022]
Abstract
Structural brain abnormalities are well documented in adult schizophrenia, but there are few studies of brain structures in early onset schizophrenia (EOS) and findings are inconsistent. Most previous EOS studies have been limited to global morphometric measures, such as whole gray matter (GM) or cerebrospinal fluid (CSF), or to single brain structures. The purpose of this study was to compare specific volumes and hemispheric lateralization in a large number of subcortical brain structures, between EOS patients and a healthy control group. High-resolution structural magnetic resonance images (MRI) and automatic brain volume segmentation were performed on 18 EOS patients and 33 healthy controls (11-18 years). A total of 29 brain structures were studied. The patients showed marked bilateral enlargements of the lateral ventricles and of the fourth ventricle, and bilateral enlargement of the caudate nuclei compared to the controls. For all other subcortical brain structures, there were no significant differences between the EOS group and the healthy control group, contrary to findings from the majority of morphometric studies of childhood or adult onset schizophrenia.
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Affiliation(s)
- Monica Juuhl-Langseth
- Research Unit for Child and Adolescent Mental Health, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
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22
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Lam M, Collinson SL, Sim K, Mackay CE, James ACD, Crow TJ. Asymmetry of lexico-semantic processing in schizophrenia changes with disease progression. Schizophr Res 2012; 134:125-30. [PMID: 22138046 DOI: 10.1016/j.schres.2011.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 10/04/2011] [Accepted: 10/29/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Are anomalies of cerebral asymmetry integral to the disease process? Here, we examined the influence of age, chronicity and age of onset of illness in 34 patients with early onset schizophrenia and 20 controls in relation to structural asymmetries of the temporal lobe and performance asymmetries on a semantic language lexical decision task. METHODS Volumetric MRI and a novel divided visual field probe of lateralised lexico-semantic language were assessed in patients with early onset schizophrenia (EOS) and controls. Novel ratios of age-illness overlap and directional asymmetry were developed in order to examine the association of chronicity factors to asymmetry. RESULTS Loss of laterality on the lexical decision task and discordant structural asymmetry were correlated with duration of illness but were not seen in younger, less chronic patients. Reduced lateral processing speed, and discordant structural asymmetry were associated with greater proportion of lifetime schizophrenia. CONCLUSION Although the conclusions are limited by the cross sectional nature of the study, anomalies of cerebral asymmetry in early onset patients may be an index of disease progression, and reflect directly on the disease process.
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Affiliation(s)
- M Lam
- Research Division, Institute of Mental Health, Singapore
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23
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Janssen J, Alemán-Gómez Y, Reig S, Schnack HG, Parellada M, Graell M, Moreno C, Moreno D, Mateos-Pérez JM, Udias JM, Arango C, Desco M. Regional specificity of thalamic volume deficits in male adolescents with early-onset psychosis. Br J Psychiatry 2012; 200:30-6. [PMID: 22116979 DOI: 10.1192/bjp.bp.111.093732] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Thalamic volume deficits are associated with psychosis but it is unclear whether the volume reduction is uniformly distributed or whether it is more severe in particular thalamic regions. AIMS To quantify whole and regional thalamic volume in males with early-onset psychosis and healthy male controls. METHOD Brain scans were obtained for 80 adolescents: 46 individuals with early-onset psychosis with a duration of positive symptoms less than 6 months and 34 healthy controls. All participants were younger than 19 years. Total thalamic volumes were assessed using FreeSurfer and FSL-FIRST, group comparisons of regional thalamic volumes were studied with a surface-based approach. RESULTS Total thalamic volume was smaller in participants with early-onset psychosis relative to controls. Regional thalamic volume reduction was most significant in the right anterior mediodorsal area and pulvinar. CONCLUSIONS In males with minimally treated early-onset psychosis, thalamic volume deficits may be most pronounced in the anterior mediodorsal and posterior pulvinar regions, adding strength to findings from post-mortem studies in adults with psychosis.
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Affiliation(s)
- Joost Janssen
- Unidad de Medicina y Cirugía Experimental, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón and Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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24
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Yang C, Wu S, Lu W, Bai Y, Gao H. WITHDRAWN: Anatomic differences in first episode schizophrenia: a deformation-based morphometry MRI Study. Compr Psychiatry 2011:S0010-440X(11)00189-1. [PMID: 22036008 DOI: 10.1016/j.comppsych.2011.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 09/04/2011] [Accepted: 09/14/2011] [Indexed: 10/15/2022] Open
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Chunlan Yang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing 100022, China
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Kumra S, Ashtari M, Wu J, Hongwanishkul D, White T, Cervellione K, Cottone J, Szeszko PR. Gray matter volume deficits are associated with motor and attentional impairments in adolescents with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:939-43. [PMID: 21216271 PMCID: PMC3319705 DOI: 10.1016/j.pnpbp.2011.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 01/02/2011] [Accepted: 01/02/2011] [Indexed: 11/16/2022]
Abstract
Cognitive deficits have been well described in adolescents with schizophrenia, but little is known about the neuroanatomical basis of these abnormalities. The authors examined whether neuropsychological deficits observed in adolescents with schizophrenia were associated with cortical gray matter volume deficits. Volumes of the superior frontal gyrus, anterior cingulate gyrus and orbital frontal lobe were outlined manually from contiguous MR images and automatically segmented into gray and white matter in 52 patients and 48 healthy volunteers. Subjects received a comprehensive neuropsychological test battery, assessing five different functional domains: executive, attention, verbal memory, motor and sensory motor. Children and adolescents with schizophrenia were found to have lower total cortical and lower superior frontal gyrus gray matter volumes and lower test scores across all functional domains compared to healthy volunteers. Among patients, the lower total cortical gray matter volume was associated with worse functioning on the attention and motor domains. Our findings point to widespread, perhaps multifocal, pathology as contributing to cognitive dysfunction in adolescents with schizophrenia.
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Affiliation(s)
- Sanjiv Kumra
- University of Minnesota, Department of Psychiatry, Minneapolis, MN 55454, USA.
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26
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Abstract
AbstractThere is emerging evidence for a connection between the surface morphology of the brain and its underlying connectivity. The foundation for this relationship is thought to be established during brain development through the shaping influences of tension exerted by viscoelastic nerve fibers. The tension-based morphogenesis results in compact wiring that enhances efficient neural processing. Individuals with schizophrenia present with multiple symptoms that can include impaired thought, action, perception, and cognition. The global nature of these symptoms has led researchers to explore a more global disruption of neuronal connectivity as a theory to explain the vast array of clinical and cognitive symptoms in schizophrenia. If cerebral function and form are linked through the organization of neural connectivity, then a disruption in neural connectivity may also alter the surface morphology of the brain. This paper reviews developmental theories of gyrification and the potential interaction between gyrification and neuronal connectivity. Studies of gyrification abnormalities in children, adolescents, and adults with schizophrenia demonstrate a relationship between disrupted function and altered morphology in the surface patterns of the cerebral cortex. This altered form may provide helpful clues in understanding the neurobiological abnormalities associated with schizophrenia.
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Micoulaud-Franchi JA, Bat-Pitault F, Da Fonseca D, Rufo M. [Early onset schizophrenia and partial agenesis of corpus callosum]. Arch Pediatr 2011; 18:189-92. [PMID: 21215603 DOI: 10.1016/j.arcped.2010.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Revised: 08/16/2010] [Accepted: 11/30/2010] [Indexed: 10/18/2022]
Abstract
We report a case of schizophrenia with partial agenesis of the corpus callosum in a 14-year-old girl. Diagnosis of schizophrenia was confirmed in the longitudinal follow-up and partial agenesis of the corpus callosum was found on brain MRI at the prodromal stage of disease. The prodromal symptom was progressive deterioration of social and academic adjustment in a context of non-specified psychotic disorder in the father. We found no abnormality in the development but a history of seizures that did not require specific treatment. Follow-up at 8 months showed an increase in negative symptoms and the onset of delusional symptoms and disorganization leading to the prescription of antipsychotic treatment. A review of the literature shows that agenesis of corpus callosum is the most reliable brain morphology abnormality in schizophrenia and is related to the neurodevelopmental and abnormal brain connectivity hypothesis in schizophrenia. Although this abnormality may be a marker of disease severity, our case report highlights the lack of longitudinal follow-up to allow the characterization of a specific outcome pattern of schizophrenic adolescents with partial agenesis of the corpus callosum.
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Affiliation(s)
- J-A Micoulaud-Franchi
- Solaris, pôle universitaire de psychiatrie, hôpital Sainte-Marguerite, Marseille, France.
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Reig S, Moreno C, Moreno D, Burdalo M, Janssen J, Parellada M, Zabala A, Desco M, Arango C. Progression of brain volume changes in adolescent-onset psychosis. Schizophr Bull 2009; 35:233-43. [PMID: 18222929 PMCID: PMC2643965 DOI: 10.1093/schbul/sbm160] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Little is known about the changes that take place in the adolescent brain over the first few years following the onset of psychosis. The present longitudinal study builds on an earlier cross-sectional report demonstrating brain abnormalities in adolescent-onset psychosis patients with a recent-onset first episode of psychosis. Magnetic resonance imaging studies were obtained at baseline and 2 years later from 21 adolescents with psychosis and 34 healthy controls matched for age, gender, and years of education. Whole-brain volumes and gray matter (GM) and cerebrospinal fluid (CSF) volumes of the frontal, parietal, temporal, and occipital lobes were measured at baseline and at 2-year follow-up. In the frontal lobe, the rate of GM volume loss was significantly higher in male patients (2.9% and 2.0%, respectively, for left and right) than in controls (1.2% and 0.7%, respectively, for left and right). In the left frontal lobe, male patients showed a significantly higher rate of CSF volume increase than controls (8.6% vs 6.4%). These differences in rates of volume change were observed in male and female patients, although only males showed significant time x diagnosis interactions. This negative finding in females should be interpreted with caution as the study was underpowered to detect change in women due to limited sample size. An exploratory analysis revealed that schizophrenia and nonschizophrenia psychotic disorders showed similar volume change patterns relative to controls. Change in clinical status was not correlated with longitudinal brain changes. Our results support progression of frontal lobe changes in males with adolescent-onset psychosis.
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Affiliation(s)
| | - Carmen Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dolores Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Maite Burdalo
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Joost Janssen
- Department of Experimental Medicine,Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Mara Parellada
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Arantzazu Zabala
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Celso Arango
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain,To whom correspondence should be addressed; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Dr Esquerdo 46, Madrid 28007, Spain; tel: 34-914265057, fax: 34-914265108, e-mail:
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29
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Yoshihara Y, Sugihara G, Matsumoto H, Suckling J, Nishimura K, Toyoda T, Isoda H, Tsuchiya KJ, Takebayashi K, Suzuki K, Sakahara H, Nakamura K, Mori N, Takei N. Voxel-based structural magnetic resonance imaging (MRI) study of patients with early onset schizophrenia. Ann Gen Psychiatry 2008; 7:25. [PMID: 19102744 PMCID: PMC2628340 DOI: 10.1186/1744-859x-7-25] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2008] [Accepted: 12/22/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Investigation into the whole brain morphology of early onset schizophrenia (EOS) to date has been sparse. We studied the regional brain volumes in EOS patients, and the correlations between regional volume measures and symptom severity. METHODS A total of 18 EOS patients (onset under 16 years) and 18 controls matched for age, gender, parental socioeconomic status, and height were examined. Voxel-based morphometric analysis using the Brain Analysis Morphological Mapping (BAMM) software package was employed to explore alterations of the regional grey (GM) and white matter (WM) volumes in EOS patients. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). RESULTS EOS patients had significantly reduced GM volume in the left parahippocampal, inferior frontal, and superior temporal gyri, compared with the controls. They also had less WM volume in the left posterior limb of the internal capsule and the left inferior longitudinal fasciculus. The positive symptom score of PANSS (higher values corresponding to more severe symptoms) was negatively related to GM volume in the bilateral posterior cingulate gyrus. The negative symptom score was positively correlated with GM volume in the right thalamus. As for the association with WM volume, the positive symptom score of PANSS was positively related to cerebellar WM (vermis region), and negatively correlated with WM in the brain stem (pons) and in the bilateral cerebellum (hemisphere region). CONCLUSION Our findings of regional volume alterations of GM and WM in EOS patients coincide with those of previous studies of adult onset schizophrenia patients. However, in brain regions that had no overall structural differences between EOS patients and controls (that is, the bilateral posterior cingulate gyrus, the right thalamus, the cerebellum, and the pons), within-subject analysis of EOS patients alone revealed that there were significant associations of the volume in these areas and the symptom severity. These findings suggest that at an early stage of the illness, especially for those with onset before brain maturation, a wide range of disturbed neural circuits, including these brain regions that show no apparent morphological changes, may contribute to the formation of the symptomatology.
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Affiliation(s)
- Yujiro Yoshihara
- Department of Psychiatry and Neurology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
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Correll CU, Smith CW, Auther AM, McLaughlin D, Shah M, Foley C, Olsen R, Lencz T, Kane JM, Cornblatt BA. Predictors of remission, schizophrenia, and bipolar disorder in adolescents with brief psychotic disorder or psychotic disorder not otherwise specified considered at very high risk for schizophrenia. J Child Adolesc Psychopharmacol 2008; 18:475-90. [PMID: 18928412 PMCID: PMC2779049 DOI: 10.1089/cap.2007.110] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to examine predictors of diagnostic and symptomatic outcome in adolescents with either psychotic disorder not otherwise specified (PsyNOS) or brief psychotic disorder (BrPsy) followed in a schizophrenia prodromal program. METHODS As part of a naturalistic study of adolescents considered at clinical high risk for schizophrenia, 26 youths (mean age, 15.9 +/- 2.6 years, 65.4% male) with psychosis not fulfilling criteria for schizophrenia/schizoaffective disorder and diagnosed with PsyNOS or BrPsy were evaluated for predictors of diagnostic and symptomatic outcome after at least 6 (mean, 22.8 +/- 19.4) months follow up. RESULTS Progression to schizophrenia, schizoaffective disorder, or psychotic bipolar disorder (n = 10, 38.5%) was predicted by fulfilling criteria for schizotypal personality disorder at baseline (p = 0.046). Development of schizophrenia/schizoaffective disorder (n = 7, 27.0%) was associated with worse executive functioning (p = 0.029) and absence of anxiety disorders (p = 0.027). Conversely, progression to bipolar disorder (n = 4, 15.4%), with (n = 3, 11.5%) or without (n = 1, 3.8%) psychosis, was associated with the presence of anxiety disorders (p = 0.014). Remission of all psychotic as well as attenuated positive or negative symptoms (n = 5, 19.4%) was predicted by Hispanic ethnicity (p = 0.0047), an initial diagnosis of BrPsy (p = 0.014), longer duration of antidepressant treatment (p = 0.035), and better attention at baseline (p = 0.042). CONCLUSIONS Results from this preliminary study suggest that patients with PsyNOS, BrPsy, or schizotypal personality disorder features in adolescence should be followed as separate risk groups in prodromal studies of schizophrenia and bipolar disorder. Executive function deficits and absence of anxiety disorders may be risk markers for schizophrenia, while presence of anxiety disorders may be linked to bipolar disorder risk. After achieving full remission, patients with sudden onset of psychosis and brief episodes could once be given the option of careful, supervised treatment discontinuation. The potential salutary effect of antidepressants during the psychotic prodrome and presence of characteristics differentiating patients at risk for schizophrenia or bipolar disorder should be investigated further.
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Affiliation(s)
- Christoph U. Correll
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York.,The Albert Einstein College of Medicine, Bronx, New York
| | - Christopher W. Smith
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York
| | - Andrea M. Auther
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York
| | - Danielle McLaughlin
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York
| | | | - Carmel Foley
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York.,The Albert Einstein College of Medicine, Bronx, New York
| | - Ruth Olsen
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York
| | - Todd Lencz
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York.,The Albert Einstein College of Medicine, Bronx, New York.,The Feinstein Institute for Medical Research, Manhasset, New York, and Brookdale Hospital, Brooklyn, New York
| | - John M. Kane
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York.,The Albert Einstein College of Medicine, Bronx, New York.,The Feinstein Institute for Medical Research, Manhasset, New York, and Brookdale Hospital, Brooklyn, New York
| | - Barbara A. Cornblatt
- The Zucker Hillside Hospital, North Shore– Long Island Jewish Health System, Glen Oaks, New York.,The Albert Einstein College of Medicine, Bronx, New York.,The Feinstein Institute for Medical Research, Manhasset, New York, and Brookdale Hospital, Brooklyn, New York
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31
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Three-dimensional mapping of the lateral ventricles in autism. Psychiatry Res 2008; 163:106-15. [PMID: 18502618 PMCID: PMC2770439 DOI: 10.1016/j.pscychresns.2007.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Revised: 10/22/2007] [Accepted: 11/07/2007] [Indexed: 11/23/2022]
Abstract
In this study, a computational mapping technique was used to examine the three-dimensional profile of the lateral ventricles in autism. T1-weighted three-dimensional magnetic resonance images of the brain were acquired from 20 males with autism (age: 10.1+/-3.5 years) and 22 male control subjects (age: 10.7+/-2.5 years). The lateral ventricles were delineated manually and ventricular volumes were compared between the two groups. Ventricular traces were also converted into statistical three-dimensional maps, based on anatomical surface meshes. These maps were used to visualize regional morphological differences in the thickness of the lateral ventricles between patients and controls. Although ventricular volumes measured using traditional methods did not differ significantly between groups, statistical surface maps revealed subtle, highly localized reductions in ventricular size in patients with autism in the left frontal and occipital horns. These localized reductions in the lateral ventricles may result from exaggerated brain growth early in life.
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Meta-analysis of magnetic resonance imaging studies of the corpus callosum in schizophrenia. Schizophr Res 2008; 101:124-32. [PMID: 18289833 DOI: 10.1016/j.schres.2008.01.005] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Revised: 12/26/2007] [Accepted: 01/04/2008] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The corpus callosum plays a pivotal role in inter-hemispheric transfer and integration of information. Magnetic resonance studies have reported callosal abnormalities in schizophrenia but findings have been inconsistent. Uncertainty has persisted despite a meta-analytic evaluation of this structure several years ago. We set out to perform a further meta-analysis with the addition of the numerous reports published on the subject to test the hypothesis that the corpus callosum is abnormal in schizophrenia. METHOD A systematic search was carried out to identify suitable magnetic resonance studies which reported callosal areas in schizophrenia compared to controls. Results from the retrieved studies were compared in a meta-analysis whilst the influence of biological and clinical variables on effect size was ascertained with meta-regression analysis. RESULTS Twenty-eight studies were identified. Corpus callosum area was reduced in schizophrenia in comparison to healthy volunteers. This effect was larger in first episode patients. Similarly, heterogeneity detected among the studies was associated with course of illness indicating that chronic subjects with schizophrenia showed larger callosal areas. There was no evidence of publication bias. CONCLUSIONS This study confirms the presence of reduced callosal areas in schizophrenia. The effect is of a larger magnitude at first presentation and less so in subjects with a chronic course generally medicated with antipsychotics.
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33
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Arango C, Moreno C, Martínez S, Parellada M, Desco M, Moreno D, Fraguas D, Gogtay N, James A, Rapoport J. Longitudinal brain changes in early-onset psychosis. Schizophr Bull 2008; 34:341-53. [PMID: 18234701 PMCID: PMC2632400 DOI: 10.1093/schbul/sbm157] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Progressive losses of cortical gray matter volumes and increases in ventricular volumes have been reported in patients with childhood-onset schizophrenia (COS) during adolescence. Longitudinal studies suggest that the rate of cortical loss seen in COS during adolescence plateaus during early adulthood. Patients with first-episode adolescent-onset schizophrenia show less marked progressive changes, although the number of studies in this population is small. Some studies show that, although less exaggerated, progressive changes are also present in nonschizophrenia early-onset psychosis. The greater loss of brain tissue seen in COS, even some years after the first episode, as compared to adolescent- or adult-onset schizophrenia may be due to variables such as sample bias (more severe, treatment refractory sample of childhood-onset patients studied), a process uniquely related to adolescent development in COS, differential brain effects of drug treatment in this population, clinical outcome, or interactions among these variables. Findings from both cross-sectional studies of first-episode patients and longitudinal studies in COS and adolescent onset support the concept of early-onset schizophrenia as a progressive neurodevelopmental disorder with both early and late developmental abnormalities. Future studies should look for correlates at a cellular level and for pathophysiological explanations of volume changes in these populations. The association of risk genes involved in circuitries associated with schizophrenia and their relationship to developmental trajectories is another promising area of future research.
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Affiliation(s)
- Celso Arango
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Carmen Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Salvador Martínez
- Instituto de Neurociencias, Universidad Miguel Hernandez, Alicante, Spain
| | - Mara Parellada
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Desco
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - David Fraguas
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Nitin Gogtay
- Child Psychiatry Branch, National Institute of Mental Health, Room 3N202, Building 10, Center Drive, Bethesda, MD 20892
| | - Anthony James
- Highfield Adolescent Unit, Warneford Hospital, Oxford, UK
| | - Judith Rapoport
- Child Psychiatry Branch, National Institute of Mental Health, Room 3N202, Building 10, Center Drive, Bethesda, MD 20892
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White T, Cullen K, Rohrer LM, Karatekin C, Luciana M, Schmidt M, Hongwanishkul D, Kumra S, Charles Schulz S, Lim KO. Limbic structures and networks in children and adolescents with schizophrenia. Schizophr Bull 2008; 34:18-29. [PMID: 17942479 PMCID: PMC2632381 DOI: 10.1093/schbul/sbm110] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Studies of adults with schizophrenia provide converging evidence for abnormalities in the limbic system. Limbic structures that show consistent patient/control differences in both postmortem and neuroimaging studies include the anterior cingulate and hippocampus, although differences in the amygdala, parahippocampal gyrus, and fornix have also been observed. Studies of white matter in children and adolescents with schizophrenia tend to show findings that are more focal than those seen in adults. Interestingly, these focal abnormalities in early-onset schizophrenia tend to be more localized to limbic regions. While it is unclear if these early limbic abnormalities are primary in the etiology of schizophrenia, there is evidence that supports a developmental progression with early limbic abnormalities evolving over time to match the neuroimaging profiles seen in adults with schizophrenia. Alternatively, the aberrations in limbic structures may be secondary to a more widespread or global pathological processes occurring with the brain that disrupt neural transmission. The goal of this article is to provide a review of the limbic system and limbic network abnormalities reported in children and adolescents with schizophrenia. These findings are compared with the adult literature and placed within a developmental context. These observations from neuroimaging studies enrich our current understanding of the neurodevelopmental model of schizophrenia and raise further questions about primary vs secondary processes. Additional research within a developmental framework is necessary to determine the putative etiologic roles for limbic and other brain abnormalities in early-onset schizophrenia.
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Affiliation(s)
- Tonya White
- Department of Psychiatry, Fairview University Medical Center, University of Minnesota, Minneapolis, MN 55454, USA.
| | - Kathryn Cullen
- Department of Psychiatry,Center for Neurobehavioral Development
| | | | | | - Monica Luciana
- Center for Neurobehavioral Development,Institute of Child Development,Department of Psychology, University of Minnesota, Minneapolis, MN
| | | | | | - Sanjiv Kumra
- Department of Psychiatry,Center for Neurobehavioral Development
| | | | - Kelvin O. Lim
- Department of Psychiatry,Center for Magnetic Resonance Research,Center for Neurobehavioral Development,Department of Psychology, University of Minnesota, Minneapolis, MN
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Frazier JA, Hodge SM, Breeze JL, Giuliano AJ, Terry JE, Moore CM, Kennedy DN, Lopez-Larson MP, Caviness VS, Seidman LJ, Zablotsky B, Makris N. Diagnostic and sex effects on limbic volumes in early-onset bipolar disorder and schizophrenia. Schizophr Bull 2008; 34:37-46. [PMID: 18003631 PMCID: PMC2632388 DOI: 10.1093/schbul/sbm120] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The limbic structures in early-onset schizophrenia-spectrum illness (SZ) and bipolar disorder (BPD) were studied to discern patterns associated with diagnosis and sex. METHODS Thirty-five youths with DSM-IV BPD without psychosis, 19 with BPD with psychosis, 20 with SZ, and 29 healthy controls (HC), similar in age (6-17 years) and sex, underwent structured and clinical interviews, neurological examination, and cognitive testing. Structural magnetic resonance images (MRIs) were acquired on a 1.5 Tesla, General Electric Signa Scanner. Differences in subcortical brain volumes, including the amygdala and hippocampus, were evaluated using two-way (diagnosis, sex) univariate analyses covarying for total cerebral volume and age. RESULTS Youth with SZ and BPD showed no differences in amygdala and hippocampal volumes. However, boys with SZ had smallest left amygdala and girls with BPD had the smallest left hippocampal volumes. In exploratory analyses, SZ showed reduced thalamic volumes bilaterally and both BPD groups had larger right nucleus accumbens (NA) volumes relative to HC. CONCLUSION There were no limbic volumetric differences between BPD and SZ. However, there were diagnosis-by-sex interactions in the amygdala and hippocampus, structures that are rich in sex hormone receptors. In addition, smaller thalamus was associated with SZ while larger right NA volumes were most related to BPD. This study underscores the importance of assessing diagnostic effects and sex effects on the brain in future studies and provides evidence that boys and girls with SZ and BPD may have differential patterns of neuropathology associated with disease expression.
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Affiliation(s)
- Jean A. Frazier
- Department of Psychiatry, Harvard Medical School,Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance,Department of Psychiatry, McLean Hospital,To whom correspondence should be addressed; tel: 781-306-8631, fax: 781-306-8644, e-mail:
| | - Steven M. Hodge
- Center for Morphometric Analysis, Massachusetts General Hospital
| | - Janis L. Breeze
- Department of Psychiatry, Harvard Medical School,Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance
| | - Anthony J. Giuliano
- Department of Psychiatry, Harvard Medical School,Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance,Department of Psychiatry, Massachusetts Mental Health Center at the Beth Israel Medical Center
| | - Janine E. Terry
- Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance
| | - Constance M. Moore
- Department of Psychiatry, Harvard Medical School,Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance,Brain Imaging Center, McLean Hospital
| | - David N. Kennedy
- Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance,Center for Morphometric Analysis, Massachusetts General Hospital,Department of Neurology, Harvard Medical School
| | - Melissa P. Lopez-Larson
- Department of Psychiatry, Harvard Medical School,Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance,Department of Psychiatry, McLean Hospital
| | - Verne S. Caviness
- Center for Morphometric Analysis, Massachusetts General Hospital,Department of Neurology, Harvard Medical School,Department of Pediatric Neurology, Massachusetts General Hospital
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School,Department of Psychiatry, Massachusetts Mental Health Center at the Beth Israel Medical Center,Department of Psychiatry, Massachusetts General Hospital
| | - Benjamin Zablotsky
- Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance
| | - Nikos Makris
- Center for Morphometric Analysis, Massachusetts General Hospital,Department of Neurology, Massachusetts General Hospital
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Chiu S, Widjaja F, Bates ME, Voelbel GT, Pandina G, Marble J, Blank JA, Day J, Brule N, Hendren RL. Anterior cingulate volume in pediatric bipolar disorder and autism. J Affect Disord 2008; 105:93-9. [PMID: 17568686 DOI: 10.1016/j.jad.2007.04.019] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Revised: 04/06/2007] [Accepted: 04/24/2007] [Indexed: 12/13/2022]
Abstract
BACKGROUND An increasing number of studies indicate the anterior cingulate gyrus (ACG) may play a role in the attention deficits associated with pediatric bipolar disorder (BD). Age, medications, and intelligence quotient (IQ) may affect ACG volume; few studies have controlled for these effects. METHODS We recruited 16 children with BD and 24 children with autism spectrum disorder (ASD); 15 children with no psychiatric diagnosis (NP) were also included. All participants were evaluated with the K-SADS and a DSM-IV Autism/Asperger's Checklist; the ADI-R was also administered to ASD participants shortly after the study began. The participants completed a brain MRI scan on a 1.5Tesla Signa GE scanner. We segmented the ACG and compared left and right ACG volumes between groups. The influence of medications on the ACG volume was assessed while controlling for the effects of age and IQ. RESULTS The left ACG volume was significantly smaller in the BD group compared to the NP (p=0.004) and ASD (p=0.006) groups. No significant differences were found in the right ACG volume. These differences do not appear to be attributable to medication use or IQ. CONCLUSIONS Pediatric BD patients have a smaller left ACG volume compared to NP children and children diagnosed with ASD. This replication and extension of previous studies suggest that the ACG volume abnormality may be a biomarker for BD.
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Affiliation(s)
- Sufen Chiu
- Department of Psychiatry and Behavioral Sciences and The Medical Investigation of Neurodevelopmental Disorders Institute, University of California, Davis Medical Center, CA 95817, United States
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van Haren NEM, Hulshoff Pol HE, Schnack HG, Cahn W, Mandl RCW, Collins DL, Evans AC, Kahn RS. Focal gray matter changes in schizophrenia across the course of the illness: a 5-year follow-up study. Neuropsychopharmacology 2007; 32:2057-66. [PMID: 17327887 DOI: 10.1038/sj.npp.1301347] [Citation(s) in RCA: 239] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Recent volumetric magnetic resonance imaging (MRI) studies have suggested brain volume changes in schizophrenia to be progressive in nature. Whether this is a global process or some brain areas are more affected than others is not known. In a 5-year longitudinal study, MRI whole brain scans were obtained from 96 patients with schizophrenia and 113 matched healthy comparison subjects. Changes over time in focal gray and white matter were measured with voxel-based morphometry throughout the brain. Over the 5-year interval, excessive decreases in gray matter density were found in patients in the left superior frontal area (Brodmann areas 9/10), left superior temporal gyrus (Brodmann area 42), right caudate nucleus, and right thalamus as compared to healthy individuals. Excessive gray matter density decrease in the superior frontal gray matter was related to increased number of hospitalizations, whereas a higher cumulative dose of clozapine and olanzapine during the scan interval was related to lesser decreases in this area. In conclusion, gray matter density loss occurs across the course of the illness in schizophrenia, predominantly in left frontal and temporal cortices. Moreover, the progression in left frontal density loss appears to be related to an increased number of psychotic episodes, with atypical antipsychotic medication attenuating these changes.
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Affiliation(s)
- Neeltje E M van Haren
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
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38
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Abstract
Early onset schizophrenia (with onset before adulthood) represents a rarer and possibly more severe form of the disorder which has received particular attention in the last two decades. Current evidence strongly suggest continuity with adult onset schizophrenia, with phenomenological, cognitive, genetic and neuroimaging data pointing towards similar neurobiological correlates and clinical deficits but worse long term outcome. Future research in early onset cases is likely to increase further our insight into the neurodevelopmental origins of schizophrenia and the complex gene-environment interactions affecting its emergence.
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Affiliation(s)
- Marinos Kyriakopoulos
- Section of Neurobiology of Psychosis, Institute of Psychiatry, De Crespigny Park, King's College, London, UK
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39
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Vidal CN, Nicolson R, DeVito TJ, Hayashi KM, Geaga JA, Drost DJ, Williamson PC, Rajakumar N, Sui Y, Dutton RA, Toga AW, Thompson PM. Mapping corpus callosum deficits in autism: an index of aberrant cortical connectivity. Biol Psychiatry 2006; 60:218-25. [PMID: 16460701 DOI: 10.1016/j.biopsych.2005.11.011] [Citation(s) in RCA: 194] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Revised: 11/01/2005] [Accepted: 11/03/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Volumetric studies have reported reductions in the size of the corpus callosum (CC) in autism, but the callosal regions contributing to this deficit have differed among studies. In this study, a computational method was used to detect and map the spatial pattern of CC abnormalities in male patients with autism. METHODS Twenty-four boys with autism (aged 10.0 +/- 3.3 years) and 26 control boys (aged 11.0 +/- 2.5 years) underwent a magnetic resonance imaging (MRI) scan at 3 Tesla. Total and regional areas of the CC were determined using traditional morphometric methods. Three-dimensional (3D) surface models of the CC were also created from the MRI scans. Statistical maps were created to visualize morphologic variability of the CC and to localize regions of callosal thinning in autism. RESULTS Traditional morphometric methods detected a significant reduction in the total callosal area and in the anterior third of the CC in patients with autism; however, 3D maps revealed significant reductions in both the splenium and genu of the CC in patients. CONCLUSIONS Statistical maps of the CC revealed callosal deficits in autism with greater precision than traditional morphometric methods. These abnormalities suggest aberrant connections between cortical regions, which is consistent with the hypothesis of abnormal cortical connectivity in autism.
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Affiliation(s)
- Christine N Vidal
- Laboratory of Neuro Imaging, Brain Mapping Division, Department of Neurology, UCLA School of Medicine, Los Angeles, California 90095-7332, USA
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40
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Kumra S, Ashtari M, Cervellione KL, Henderson I, Kester H, Roofeh D, Wu J, Clarke T, Thaden E, Kane JM, Rhinewine J, Lencz T, Diamond A, Ardekani BA, Szeszko PR. White matter abnormalities in early-onset schizophrenia: a voxel-based diffusion tensor imaging study. J Am Acad Child Adolesc Psychiatry 2005; 44:934-41. [PMID: 16113622 DOI: 10.1097/01.chi.0000170553.15798.94] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate abnormalities in the structural integrity of brain white matter as suggested by diffusion tensor imaging in adolescents with early-onset schizophrenia (onset of psychosis by age 18). METHOD Twenty-six patients with schizophrenia and 34 age- and gender-matched healthy volunteers received diffusion tensor imaging and structural magnetic resonance imaging examinations. Fractional anisotropy maps were compared between groups in the white matter using a voxelwise analysis after intersubject registration to Talairach space. RESULTS Compared with healthy volunteers, patients demonstrated lower fractional anisotropy values in the left anterior cingulate region in close proximity to the caudate nucleus (95% confidence interval of schizophrenic-healthy: -66 to -20). Using regression analysis, the rate of change in fractional anisotropy differed significantly between groups in this region across the age span examined (10-20 years), after adjusting for group differences in premorbid intellectual capacity and parental socioeconomic status. There were no areas of significantly higher fractional anisotropy in patients compared with healthy volunteers. CONCLUSIONS These data suggest that early-onset schizophrenia is associated with a disruption in the structural integrity of white matter tracts in the anterior cingulate region. These structural abnormalities may contribute to the deficits in motivation, attention, memory, and higher executive functions in adolescents with schizophrenia.
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Affiliation(s)
- Sanjiv Kumra
- Department of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY 11004, USA.
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41
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Correll CU, Lencz T, Smith CW, Auther AM, Nakayama EY, Hovey L, Olsen R, Shah M, Foley C, Cornblatt BA. Prospective study of adolescents with subsyndromal psychosis: characteristics and outcome. J Child Adolesc Psychopharmacol 2005; 15:418-33. [PMID: 16092908 DOI: 10.1089/cap.2005.15.418] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to examine the characteristics and outcome of adolescents with psychotic disorder not otherwise specified (PsyNOS) and brief psychotic disorder (BrPsy), two neglected subsyndromal diagnostic entities. METHODS As part of an ongoing, naturalistic study investigating adolescents considered to be prodromal for schizophrenia, 29 youngsters (mean age, 16.2 +/- 2.7 years) with PsyNOS or BrPsy were identified as theoretically at highest risk for schizophrenia and followed for over 6 (mean, 22.8 +/- 19.4) months. RESULTS Contrary to our expectations, only 7 of the 26 individuals (27.0%) with follow-up data developed schizophrenia or schizoaffective disorder, and only 2 subjects (7.7%) retained their diagnosis of BrPsy/PsyNOS. The most frequent other diagnoses at follow-up were mood disorders (34.6%), personality disorders (11.5%), and obsessive-compulsive disorder (7.7%). Regarding severity of outcome, 38.5% of the patients progressed to a syndromal psychotic disorder, 23.1% continued to have attenuated positive symptoms, and 38.4% improved to having attenuated negative symptoms only, or no positive or negative symptoms. BrPsy was associated with lower maximum levels of negative symptoms (p = 0.02) and higher likelihood of symptom remission (p = 0.02). CONCLUSIONS This study indicates that psychotic symptoms not fulfilling criteria for schizophrenia or a psychotic mood disorder are unreliable predictors of a syndromal psychotic disorder outcome at 2 years. Long-term studies of PsyNOS and BrPsy are needed to clarify where these disorders fall in the developmental course of schizophrenia.
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Affiliation(s)
- Christoph U Correll
- The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY 11004, USA.
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Taylor JL, Blanton RE, Levitt JG, Caplan R, Nobel D, Toga AW. Superior temporal gyrus differences in childhood-onset schizophrenia. Schizophr Res 2005; 73:235-41. [PMID: 15653266 DOI: 10.1016/j.schres.2004.07.023] [Citation(s) in RCA: 32] [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: 07/21/2004] [Accepted: 07/21/2004] [Indexed: 10/26/2022]
Abstract
The posterior superior temporal gyrus (STG) is the approximate site of Wernicke's area, a language region, which in previous studies has been reported to be abnormal in adults with schizophrenia. The present study assesses volumetric differences in the superior temporal gyrus of subjects with childhood-onset schizophrenia (COS). MRI scans of 18 subjects diagnosed with childhood-onset schizophrenia and 16 age- and sex-matched normals were analyzed to assess possible volume differences. The COS subjects displayed significant enlargement of the right posterior superior temporal gyrus, showing white matter increases bilaterally in this region. Our findings are consistent with studies that have found increased volumes in temporal lobe regions in COS and may provide a possible neural correlate for the language impairment observed in COS patients.
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Affiliation(s)
- Janelle L Taylor
- Laboratory of Neuro Imaging, Deptartment of Neurology, Division of Brain Mapping, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA
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Moran-Gates T, Gan L, Park YS, Zhang K, Baldessarini RJ, Tarazi FI. Repeated antipsychotic drug exposurein developing rats: Dopamine receptor effects. Synapse 2005; 59:92-100. [PMID: 16270300 DOI: 10.1002/syn.20220] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Antipsychotic drugs are often prescribed to juvenile psychiatric patients, though their cerebral effects during development are incompletely described. Accordingly, we studied the effects of repeated treatment with dissimilar antipsychotic drugs on dopamine (DA) receptors in juvenile vs. adult rats. Tissue levels of DA receptor types (D1, D2, D3, and D4) in forebrain regions of juvenile rats were quantified after 3 weeks of daily treatment with representative first- (fluphenazine) and second-generation (clozapine and olanzapine) antipsychotics, and compared with similarly treated adult rats examined in previous studies. Fluphenazine, clozapine, and olanzapine all decreased D1 receptors in dorsolateral frontal and medial prefrontal cortex (MPC) of juvenile, but not adult rats. Conversely, all three test agents increased D2 labeling in MPC of adult, but not young animals. Fluphenazine and olanzapine, but not clozapine, also increased D2 receptor levels in hippocampus, and D4 levels in nucleus accumbens (NAc) and caudate-putamen (CPu) in both juvenile and adult brain. D3 receptors were not altered by any treatment in any brain region at either age. Only some DA receptor adaptations to antipsychotic treatment are shared by developing and mature animals. Developmental differences in DA receptor responses may account for differences in clinical effects of antipsychotic drugs between young and adult psychiatric patients.
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Affiliation(s)
- Taylor Moran-Gates
- Mailman Research Center, McLean Division of Massachusetts General Hospital, Belmont 02478-9106, and Department of Psychiatry and Neuroscience Program, Harvard Medical School, Boston, Massachusetts, USA
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Biederman J, Petty C, Faraone SV, Seidman L. Phenomenology of childhood psychosis: findings from a large sample of psychiatrically referred youth. J Nerv Ment Dis 2004; 192:607-14. [PMID: 15348977 DOI: 10.1097/01.nmd.0000138228.59938.c3] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our objective was to evaluate the scope and clinical correlates of psychotic phenomena in psychiatrically referred children and adolescents. Subjects were 1657 psychiatrically referred youth (mean age = 10.9 years) evaluated from 1991 to 2002. DSM-III-R diagnoses were obtained through maternal report by using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version. Childhood-onset psychosis was defined by the presence of delusions or hallucinations. Childhood-onset psychosis was identified in 8% of psychiatrically referred youth. It was associated with a chronic course and high levels of impairment. Comorbidity with disruptive, mood, and anxiety disorders was very severe, with only one of the 132 identified youth with psychosis not having at least one comorbidity. In conclusion, childhood-onset psychosis in referred youth is common and highly morbid. It remains an important topic of research deserving full clinical and scientific attention.
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Affiliation(s)
- Joseph Biederman
- Clinical Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, USA
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O'Neill J, Levitt J, Caplan R, Asarnow R, McCracken JT, Toga AW, Alger JR. 1H MRSI evidence of metabolic abnormalities in childhood-onset schizophrenia. Neuroimage 2004; 21:1781-9. [PMID: 15050598 DOI: 10.1016/j.neuroimage.2003.11.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2003] [Revised: 11/12/2003] [Accepted: 11/13/2003] [Indexed: 11/18/2022] Open
Abstract
In adult schizophrenia, magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) have revealed volumetric and metabolic defects in multiple brain regions, among them the anterior cingulate, frontal cortex, striatum, thalamus, parietal cortex, and frontal and parietal white matter. This study used proton magnetic resonance spectroscopic imaging ((1)H MRSI) to identify potential metabolic abnormalities in these regions in childhood-onset schizophrenia. (1)H MRSI was acquired at 1.5 T and 272 ms echo time in 11 children and adolescents with schizophrenia (aged 7-18 years; seven boys, four girls; all but two medicated) and 20 age-matched healthy controls (10 boys, 10 girls). Absolute levels of N-acetyl compounds (NAA), creatine plus phosphocreatine (Cr), and choline compounds (Cho) were compared among groups in each region. In schizophrenic patients relative to controls, Cr was 14.3% higher in superior anterior cingulate (mean of left and right hemispheres). Cho was higher in superior anterior cingulate (30.3%), frontal cortex (13.3%), and caudate head (13.5%). In the thalamus, there was also a diagnosis-by-gender interaction, whereby NAA was lower in patients for male but not for female subjects. Elevated Cr suggests abnormal local cell-energy demand and elevated Cho is consistent with a prior proposal that patients with early age-of-onset schizophrenia exhibit phospholipid membrane disturbances. Low NAA may reflect diminished neuronal integrity.
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Affiliation(s)
- Joseph O'Neill
- Division of Child and Adolescent Psychiatry, University of California at Los Angeles, Los Angeles, CA 90095, USA.
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Haselgrove J, Hunte M, Hurh P, Steen RG. Direct comparison of two methods to measure T1: in vitro and in vivo values by echo-planar imaging and by segmented k-space imaging. Magn Reson Imaging 2004; 22:291-8. [PMID: 15062924 DOI: 10.1016/j.mri.2004.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2003] [Accepted: 01/26/2004] [Indexed: 11/28/2022]
Abstract
We test a hypothesis that proton T(1) is accurately measured independent of the physics inherent to the method. We used two well-validated but quite different imaging methods to measure T(1) in phantoms and in humans; an echo-planar imaging T-one measurement (EPITOME) method, and a segmented k-space acquisition precise and accurate inversion recovery (TurboPAIR) method. Agreement between the methods was generally excellent; the square of the correlation coefficient (r(2)) in phantoms was 0.9996. The r(2) in brain tissue of volunteers was 0.79 overall, and 0.85 if cortical gray matter and corpus callosum were excluded. Nevertheless, small but significant differences were observed between methods in vivo and T(1) measurements were sensitive to tissue type, although measurements could be made comparable. The major difference between the methods is that EPITOME takes 97 s to image 15 slices at low resolution, while TurboPAIR takes 240 s to image one slice at high resolution.
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Affiliation(s)
- John Haselgrove
- Department of Radiology, Children's Hospital of Pennsylvania, Philadelphia, PA, USA
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Abstract
BACKGROUND Abnormalities in cerebral lateralization are thought to reflect early neurodevelopmental defects in schizophrenia. The aim of this study was to examine whether there is abnormal brain lateralization in early onset schizophrenia (EOS) and whether it is related to the unusually early onset of the disorder. METHODS Adolescent patients with recent onset schizophrenia and an equal number of matched control subjects participated in the study. The volumes of the occipitoparietal, sensorimotor, premotor, prefrontal, and temporal regions were measured bilaterally from magnetic resonance images using stereological methods. Asymmetry indexes were calculated for each region using the formula ([R - L]/[R + L]) x 100. A composite index of asymmetry (torque) was computed as the sum of the five index scores. RESULTS A total of 40 patients with EOS and 40 age-matched controls were enrolled. There were no group differences in demographic characteristics. No group differences in brain asymmetry measures were seen in any of the brain regions examined. CONCLUSIONS The unusually early onset of schizophrenia in this population does not appear to be associated with abnormalities in hemispheric lateralization.
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Affiliation(s)
- Michael Hadjulis
- Division of Psychological Medicine, Institute of Psychiatry, Kings College London, London, United Kingdom
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48
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Keller A, Jeffries NO, Blumenthal J, Clasen LS, Liu H, Giedd JN, Rapoport JL. Corpus callosum development in childhood-onset schizophrenia. Schizophr Res 2003; 62:105-14. [PMID: 12765750 DOI: 10.1016/s0920-9964(02)00354-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Corpus callosum (CC) size and interhemispheric communication differences have been reported between patients with schizophrenia and normal controls. Childhood-onset schizophrenia (COS) is a severe form of the disorder that is continuous with later-onset disorder. Corpus callosal area was examined for COS at initial scan and prospectively through adolescence, and related to other developmental abnormalities for this group. METHOD A total of 113 anatomic brain MRI scans were obtained from 55 COS (22 female) and 110 scans from 56 age- and gender-matched healthy volunteers (22 female), across ages 8-24. Baseline and prospective rescans were obtained at approximately 2-year intervals. The midsagittal areas for total corpus callosum and seven subregions were calculated using an automated system. Cross-sectional and longitudinal data were combined using mixed model regression analysis to compare developmental changes for the two groups. RESULTS No diagnostic differences were seen at time of initial scan. Longitudinally, and in contrast to healthy volunteers, patients with schizophrenia showed a significant difference in developmental trajectory for the area of the splenium, both before (p=0.012) and after (p=0.05) adjustment for total cerebral volume. The area of the splenium becomes significantly smaller in COS, starting at about age 22. CONCLUSION Patients with schizophrenia showed a significant difference in developmental trajectory for the splenial area, which seems to decline for COS. If replicated, this may reflect anticipated late occipital and extrastriate changes in brain regions.
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Affiliation(s)
- Audrey Keller
- Child Psychiatry Branch, National Institute of Mental Health, Building 10, Room 3N 202, 10 Center Drive MSC 1600, Bethesda, MD 20892-1600, USA
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De Bellis MD, Keshavan MS, Frustaci K, Shifflett H, Iyengar S, Beers SR, Hall J. Superior temporal gyrus volumes in maltreated children and adolescents with PTSD. Biol Psychiatry 2002; 51:544-52. [PMID: 11950456 DOI: 10.1016/s0006-3223(01)01374-9] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The structure and function of the superior temporal gyrus (STG), a structure involved in receptive and nonverbal auditory and language processing, is understudied in posttraumatic stress disorder (PTSD). Event-related potential abnormalities were previously reported in PTSD, implicating the existence of dysfunction in the primary auditory cortex and adjacent anterior auditory cortex of the STG in adult PTSD. METHODS Anatomic magnetic resonance imaging (MRI) volumetric analysis of the superior temporal gyrus were performed in 43 maltreated children and adolescents with PTSD and 61 nonmaltreated healthy control subjects. RESULTS Unadjusted STG gray matter volumes were larger in maltreated subjects with PTSD than in control subjects, whereas STG white matter volumes were smaller in maltreated subjects with PTSD than in control subjects. After adjusting for differences in cerebral volume, right, left, and total superior temporal gyrus volumes were relatively larger in PTSD subjects compared with control subjects. After covarying for differences in cerebral gray matter volumes, regression analysis showed that PTSD subjects had significantly greater STG gray matter volumes in most, and in particularly right-sided STG measurements. Furthermore, findings of significant side-by-diagnosis interactions for STG and STG gray but not white matter STG volumes suggest that there is a more pronounced right > left asymmetry in total and posterior STG volumes but a loss of the left > right asymmetry seen in total, anterior, and posterior STG gray matter volumes in PTSD subjects compared with control subjects. CONCLUSIONS These STG findings may suggest developmental alterations in maltreatment-related pediatric PTSD.
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Affiliation(s)
- Michael D De Bellis
- University of Pittsburgh Medical Center, Developmental Traumatology Program (Developmental Family Health Clinic and Neuroimaging Laboratory), Western Psychiatric Institute and Clinic, Rm 392, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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50
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Kumra S, Shaw M, Merka P, Nakayama E, Augustin R. Childhood-onset schizophrenia: research update. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2001; 46:923-30. [PMID: 11816313 DOI: 10.1177/070674370104601004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This review is a research update of recent literature related to childhood-onset schizophrenia (onset of psychotic symptoms by age 12 years). This subgroup of patients has attracted considerable research interest because patients with a childhood onset may represent a more homogeneous patient population in which to search for risk or etiologic factors. We examine data indicating that childhood-onset schizophrenia (COS) shares the same clinical and neurobiologic features as later-onset forms of the disorder. Compared with adults with schizophrenia, however, this subgroup of patients appears to have more severe premorbid neuro-developmental abnormalities, more cytogenetic anomalies, and potentially greater family histories of schizophrenia and associated spectrum disorders. While preliminary, these data indicate that a greater genetic vulnerability may be one of the underpinnings of COS. Future studies of this subgroup may provide important clues as to the genetic basis for schizophrenia and how gene products influence certain features of the disease, such as age of onset and mode of inheritance.
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Affiliation(s)
- S Kumra
- Albert Einstein College of Medicine, Bronx, New York, USA.
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