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Guo J, He C, Song H, Gao H, Yao S, Dong SS, Yang TL. Unveiling Promising Neuroimaging Biomarkers for Schizophrenia Through Clinical and Genetic Perspectives. Neurosci Bull 2024; 40:1333-1352. [PMID: 38703276 PMCID: PMC11365900 DOI: 10.1007/s12264-024-01214-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/08/2024] [Indexed: 05/06/2024] Open
Abstract
Schizophrenia is a complex and serious brain disorder. Neuroscientists have become increasingly interested in using magnetic resonance-based brain imaging-derived phenotypes (IDPs) to investigate the etiology of psychiatric disorders. IDPs capture valuable clinical advantages and hold biological significance in identifying brain abnormalities. In this review, we aim to discuss current and prospective approaches to identify potential biomarkers for schizophrenia using clinical multimodal neuroimaging and imaging genetics. We first described IDPs through their phenotypic classification and neuroimaging genomics. Secondly, we discussed the applications of multimodal neuroimaging by clinical evidence in observational studies and randomized controlled trials. Thirdly, considering the genetic evidence of IDPs, we discussed how can utilize neuroimaging data as an intermediate phenotype to make association inferences by polygenic risk scores and Mendelian randomization. Finally, we discussed machine learning as an optimum approach for validating biomarkers. Together, future research efforts focused on neuroimaging biomarkers aim to enhance our understanding of schizophrenia.
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Affiliation(s)
- Jing Guo
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Changyi He
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Huimiao Song
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Huiwu Gao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Shi Yao
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524000, China
| | - Shan-Shan Dong
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Tie-Lin Yang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics and Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China.
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2
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Badke D’Andrea C, Marek S, Van AN, Miller RL, Earl EA, Stewart SB, Dosenbach NUF, Schlaggar BL, Laumann TO, Fair DA, Gordon EM, Greene DJ. Thalamo-cortical and cerebello-cortical functional connectivity in development. Cereb Cortex 2023; 33:9250-9262. [PMID: 37293735 PMCID: PMC10492576 DOI: 10.1093/cercor/bhad198] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023] Open
Abstract
The thalamus is a critical relay center for neural pathways involving sensory, motor, and cognitive functions, including cortico-striato-thalamo-cortical and cortico-ponto-cerebello-thalamo-cortical loops. Despite the importance of these circuits, their development has been understudied. One way to investigate these pathways in human development in vivo is with functional connectivity MRI, yet few studies have examined thalamo-cortical and cerebello-cortical functional connectivity in development. Here, we used resting-state functional connectivity to measure functional connectivity in the thalamus and cerebellum with previously defined cortical functional networks in 2 separate data sets of children (7-12 years old) and adults (19-40 years old). In both data sets, we found stronger functional connectivity between the ventral thalamus and the somatomotor face cortical functional network in children compared with adults, extending previous cortico-striatal functional connectivity findings. In addition, there was more cortical network integration (i.e. strongest functional connectivity with multiple networks) in the thalamus in children than in adults. We found no developmental differences in cerebello-cortical functional connectivity. Together, these results suggest different maturation patterns in cortico-striato-thalamo-cortical and cortico-ponto-cerebellar-thalamo-cortical pathways.
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Affiliation(s)
- Carolina Badke D’Andrea
- Department of Cognitive Science, University of California San Diego, La Jolla, CA 92093, United States
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, United States
| | - Scott Marek
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, United States
| | - Andrew N Van
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 63130, United States
| | - Ryland L Miller
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States
| | - Eric A Earl
- Data Science and Sharing Team, National Institute of Mental Health, NIH, DHHS, Bethesda, MD 20899, United States
| | - Stephanie B Stewart
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, United States
| | - Nico U F Dosenbach
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 63130, United States
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, United States
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO 63110, United States
| | | | - Timothy O Laumann
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States
| | - Damien A Fair
- Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, MN 55455, United States
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, United States
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN 55455, United States
| | - Evan M Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, United States
| | - Deanna J Greene
- Department of Cognitive Science, University of California San Diego, La Jolla, CA 92093, United States
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3
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Barth C, Kelly S, Nerland S, Jahanshad N, Alloza C, Ambrogi S, Andreassen OA, Andreou D, Arango C, Baeza I, Banaj N, Bearden CE, Berk M, Bohman H, Castro-Fornieles J, Chye Y, Crespo-Facorro B, de la Serna E, Díaz-Caneja CM, Gurholt TP, Hegarty CE, James A, Janssen J, Johannessen C, Jönsson EG, Karlsgodt KH, Kochunov P, Lois NG, Lundberg M, Myhre AM, Pascual-Diaz S, Piras F, Smelror RE, Spalletta G, Stokkan TS, Sugranyes G, Suo C, Thomopoulos SI, Tordesillas-Gutiérrez D, Vecchio D, Wedervang-Resell K, Wortinger LA, Thompson PM, Agartz I. In vivo white matter microstructure in adolescents with early-onset psychosis: a multi-site mega-analysis. Mol Psychiatry 2023; 28:1159-1169. [PMID: 36510004 PMCID: PMC10005938 DOI: 10.1038/s41380-022-01901-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022]
Abstract
Emerging evidence suggests brain white matter alterations in adolescents with early-onset psychosis (EOP; age of onset <18 years). However, as neuroimaging methods vary and sample sizes are modest, results remain inconclusive. Using harmonized data processing protocols and a mega-analytic approach, we compared white matter microstructure in EOP and healthy controls using diffusion tensor imaging (DTI). Our sample included 321 adolescents with EOP (median age = 16.6 years, interquartile range (IQR) = 2.14, 46.4% females) and 265 adolescent healthy controls (median age = 16.2 years, IQR = 2.43, 57.7% females) pooled from nine sites. All sites extracted mean fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) for 25 white matter regions of interest per participant. ComBat harmonization was performed for all DTI measures to adjust for scanner differences. Multiple linear regression models were fitted to investigate case-control differences and associations with clinical variables in regional DTI measures. We found widespread lower FA in EOP compared to healthy controls, with the largest effect sizes in the superior longitudinal fasciculus (Cohen's d = 0.37), posterior corona radiata (d = 0.32), and superior fronto-occipital fasciculus (d = 0.31). We also found widespread higher RD and more localized higher MD and AD. We detected significant effects of diagnostic subgroup, sex, and duration of illness, but not medication status. Using the largest EOP DTI sample to date, our findings suggest a profile of widespread white matter microstructure alterations in adolescents with EOP, most prominently in male individuals with early-onset schizophrenia and individuals with a shorter duration of illness.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Sinead Kelly
- Department of Psychosis Studies, King's College London, London, UK
| | - Stener Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Dimitrios Andreou
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Hannes Bohman
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Josefina Castro-Fornieles
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Yann Chye
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Benedicto Crespo-Facorro
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Department of Psychiatry, CIBERSAM, IBiS-CSIC, Sevilla, Spain
| | - Elena de la Serna
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Tiril P Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Anthony James
- Highfield Unit, Warneford Hospital, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Cecilie Johannessen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik G Jönsson
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Katherine H Karlsgodt
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MA, USA
| | - Noemi G Lois
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Mathias Lundberg
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Anne M Myhre
- Section of Child and Adolescent Mental Health Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Saül Pascual-Diaz
- Magnetic Resonance Imaging Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Runar E Smelror
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Therese S Stokkan
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gisela Sugranyes
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Chao Suo
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Diana Tordesillas-Gutiérrez
- Department of Radiology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Santander (Cantabria), Spain
- Advanced Computing and e-Science, Instituto de Física de Cantabria (UC-CSIC), Santander (Cantabria), Spain
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Kirsten Wedervang-Resell
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Laura A Wortinger
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
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4
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Alnafisah RS, Reigle J, Eladawi MA, O'Donovan SM, Funk AJ, Meller J, Mccullumsmith RE, Shukla R. Assessing the effects of antipsychotic medications on schizophrenia functional analysis: a postmortem proteome study. Neuropsychopharmacology 2022; 47:2033-2041. [PMID: 35354897 PMCID: PMC9556610 DOI: 10.1038/s41386-022-01310-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/01/2022] [Accepted: 03/11/2022] [Indexed: 12/15/2022]
Abstract
Antipsychotic drugs (APDs) are effective in treating positive symptoms of schizophrenia (SCZ). However, they have a substantial impact on postmortem studies. As most cohorts lack samples from drug-naive patients, many studies, rather than understanding SCZ pathophysiology, are analyzing the drug effects. We hypothesized that comparing SCZ-altered and APD-influenced signatures derived from the same cohort can provide better insight into SCZ pathophysiology. For this, we performed LCMS-based proteomics on dorsolateral prefrontal cortex (DLPFC) samples from control and SCZ subjects and used statistical approaches to identify SCZ-altered and APD-influenced proteomes, validated experimentally using independent cohorts and published datasets. Functional analysis of both proteomes was contrasted at the biological-pathway, cell-type, subcellular-synaptic, and drug-target levels. In silico validation revealed that the SCZ-altered proteome was conserved across several studies from the DLPFC and other brain areas. At the pathway level, SCZ influenced changes in homeostasis, signal-transduction, cytoskeleton, and dendrites, whereas APD influenced changes in synaptic-signaling, neurotransmitter-regulation, and immune-system processes. At the cell-type level, the SCZ-altered and APD-influenced proteomes were associated with two distinct striatum-projecting layer-5 pyramidal neurons regulating dopaminergic-secretion. At the subcellular synaptic level, compensatory pre- and postsynaptic events were observed. At the drug-target level, dopaminergic processes influenced the SCZ-altered upregulated-proteome, whereas nondopaminergic and a diverse array of non-neuromodulatory mechanisms influenced the downregulated-proteome. Previous findings were not independent of the APD effect and thus require re-evaluation. We identified a hyperdopaminergic cortex and drugs targeting the cognitive SCZ-symptoms and discussed their influence on SCZ pathology in the context of the cortico-striatal pathway.
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Affiliation(s)
- Rawan S Alnafisah
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - James Reigle
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, USA
| | | | - Sinead M O'Donovan
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Adam J Funk
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Jaroslaw Meller
- Department of Pharmacology and Systems Physiology, University of Cincinnati, Cincinnati, OH, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, OH, USA
| | - Robert E Mccullumsmith
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
- Neurosciences Institute, ProMedica, Toledo, OH, USA
| | - Rammohan Shukla
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
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Cobia D, Rich C, Smith MJ, Engel Gonzalez P, Cronenwett W, Csernansky JG, Wang L. Thalamic Shape Abnormalities Differentially Relate to Cognitive Performance in Early-Onset and Adult-Onset Schizophrenia. Front Psychiatry 2022; 13:803234. [PMID: 35479490 PMCID: PMC9035552 DOI: 10.3389/fpsyt.2022.803234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Early-onset schizophrenia (EOS) shares many biological and clinical features with adult-onset schizophrenia (AOS), but may represent a unique subgroup with greater susceptibility for disease onset and worsened symptomatology and progression, which could potentially derive from exaggerated neurodevelopmental abnormalities. Neurobiological explanations of schizophrenia have emphasized the involvement of deep-brain structures, particularly alterations of the thalamus, which have been linked to core features of the disorder. The aim of this study was to compare thalamic shape abnormalities between EOS and AOS subjects and determine whether unique behavioral profiles related to these differences. It was hypothesized abnormal thalamic shape would be observed in anterior, mediodorsal and pulvinar regions in both schizophrenia groups relative to control subjects, but exacerbated in EOS. Magnetic resonance T1-weighted images were collected from adult individuals with EOS (n = 28), AOS (n = 33), and healthy control subjects (n = 60), as well as collection of clinical and cognitive measures. Large deformation high-dimensional brain mapping was used to obtain three-dimensional surfaces of the thalamus. General linear models were used to compare groups on surface shape features, and Pearson correlations were used to examine relationships between thalamic shape and behavioral measures. Results revealed both EOS and AOS groups demonstrated significant abnormal shape of anterior, lateral and pulvinar thalamic regions relative to CON (all p < 0.007). Relative to AOS, EOS exhibited exacerbated abnormalities in posterior lateral, mediodorsal and lateral geniculate thalamic regions (p = 0.003). Thalamic abnormalities related to worse episodic memory in EOS (p = 0.03) and worse working memory (p = 0.047) and executive functioning (p = 0003) in AOS. Overall, findings suggest thalamic abnormalities are a prominent feature in both early- and late-onset schizophrenia, but exaggerated in EOS and have different brain-behavior profiles for each. The persistence of these abnormalities in adult EOS patients suggests they may represent markers of disrupted neurodevelopment that uniquely relate to the clinical and cognitive aspects of the illness.
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Affiliation(s)
- Derin Cobia
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, United States.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Chaz Rich
- Department of Psychology, University of Notre Dame, Notre Dame, IN, United States
| | - Matthew J Smith
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Pedro Engel Gonzalez
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Will Cronenwett
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - John G Csernansky
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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6
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Fronto-Parietal Gray Matter Volume Loss Is Associated with Decreased Working Memory Performance in Adolescents with a First Episode of Psychosis. J Clin Med 2021; 10:jcm10173929. [PMID: 34501377 PMCID: PMC8432087 DOI: 10.3390/jcm10173929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022] Open
Abstract
Cognitive maturation during adolescence is modulated by brain maturation. However, it is unknown how these processes intertwine in early onset psychosis (EOP). Studies examining longitudinal brain changes and cognitive performance in psychosis lend support for an altered development of high-order cognitive functions, which parallels progressive gray matter (GM) loss over time, particularly in fronto-parietal brain regions. We aimed to assess this relationship in a subsample of 33 adolescents with first-episode EOP and 47 matched controls over 2 years. Backwards stepwise regression analyses were conducted to determine the association and predictive value of longitudinal brain changes over cognitive performance within each group. Fronto-parietal GM volume loss was positively associated with decreased working memory in adolescents with psychosis (frontal left (B = 0.096, p = 0.008); right (B = 0.089, p = 0.015); parietal left (B = 0.119, p = 0.007), right (B = 0.125, p = 0.015)) as a function of age. A particular decrease in frontal left GM volume best predicted a significant amount (22.28%) of the variance of decreased working memory performance over time, accounting for variance in age (14.9%). No such association was found in controls. Our results suggest that during adolescence, EOP individuals seem to follow an abnormal neurodevelopmental trajectory, in which fronto-parietal GM volume reduction is associated with the differential age-related working memory dysfunction in this group.
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7
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Romero JE, Coupe P, Lanuza E, Catheline G, Manjón JV. Toward a unified analysis of cerebellum maturation and aging across the entire lifespan: A MRI analysis. Hum Brain Mapp 2021; 42:1287-1303. [PMID: 33385303 PMCID: PMC7927303 DOI: 10.1002/hbm.25293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 12/23/2022] Open
Abstract
Previous literature about the structural characterization of the human cerebellum is related to the context of a specific pathology or focused in a restricted age range. In fact, studies about the cerebellum maturation across the lifespan are scarce and most of them considered the cerebellum as a whole without investigating each lobule. This lack of study can be explained by the lack of both accurate segmentation methods and data availability. Fortunately, during the last years, several cerebellum segmentation methods have been developed and many databases comprising subjects of different ages have been made publically available. This fact opens an opportunity window to obtain a more extensive analysis of the cerebellum maturation and aging. In this study, we have used a recent state‐of‐the‐art cerebellum segmentation method called CERES and a large data set (N = 2,831 images) from healthy controls covering the entire lifespan to provide a model for 12 cerebellum structures (i.e., lobules I‐II, III, IV, VI, Crus I, Crus II, VIIB, VIIIA, VIIIB, IX, and X). We found that lobules have generally an evolution that follows a trajectory composed by a fast growth and a slow degeneration having sometimes a plateau for absolute volumes, and a decreasing tendency (faster in early ages) for normalized volumes. Special consideration is dedicated to Crus II, where slow degeneration appears to stabilize in elder ages for absolute volumes, and to lobule X, which does not present any fast growth during childhood in absolute volumes and shows a slow growth for normalized volumes.
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Affiliation(s)
- José E Romero
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Valencia, Spain
| | - Pierrick Coupe
- CNRS, University of Bordeaux, Bordeaux INP, LABRI, UMR5800, Talence, France.,CNRS, EPHE PSL Research University of, INCIA, UMR 5283, University of Bordeaux, Bordeaux, France
| | - Enrique Lanuza
- Department of Cell Biology, University of Valencia, Valencia, Spain
| | - Gwenaelle Catheline
- CNRS, EPHE PSL Research University of, INCIA, UMR 5283, University of Bordeaux, Bordeaux, France
| | - José V Manjón
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Valencia, Spain
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8
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Jiang D, Qiu X, Ren S, Hua F, Kong Y, Guan Y, Xie F. Maturation of topological organization of brain networks in male adolescent rats: A longitudinal FDG-PET study. Neurosci Lett 2020; 723:134864. [PMID: 32109556 DOI: 10.1016/j.neulet.2020.134864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/20/2020] [Accepted: 02/23/2020] [Indexed: 11/30/2022]
Abstract
Recent studies have found developmental alterations of the brain during the adolescent period. However, maturation-related changes of the topological properties in brain networks are unexplored so far. We therefore used fluoro-d-glucose positron emission tomography (FDG PET) to explore the maturation-related topological metabolic changes in brain networks from adolescence to adulthood with a longitudinal study in rats (male, n = 6), followed by a graph theoretical analysis. Our results showed reduced normalization characteristic path length and increased small world index of brain networks. Specifically, we found that relative to adulthood, in the adolescent stage rats had significantly increased nodal centrality in right entorhinal cortex, left frontal association cortex, and cerebellum, areas relating to memory, executive function and higher cognitive control and motor control; and significantly reduced nodal centrality in left superior colliculus and left retrosplenial cortex. These findings suggest that moving from adolescence to adulthood, networks of the brain mature accompanied by reassignment of hub regions to increase network efficiency. These results provide an animal model of brain network maturation from adolescence to adulthood which are relevant for understanding of development of psychiatric disorders during adolescence or transition from adolescence to adulthood.
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Affiliation(s)
- Donglang Jiang
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiangzhe Qiu
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for Neuroinformation of Ministry of Education, Center for Information in Biomedicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Shuhua Ren
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Fengchun Hua
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yanyan Kong
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China; Molecular Imaging Center, The Academy of Integrative Medicine of Fudan University, Shanghai, 200040, China; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China
| | - Fang Xie
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China.
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9
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Duan L, Zhu G. Mapping Theme Trends and Knowledge Structure of Magnetic Resonance Imaging Studies of Schizophrenia: A Bibliometric Analysis From 2004 to 2018. Front Psychiatry 2020; 11:27. [PMID: 32116844 PMCID: PMC7019376 DOI: 10.3389/fpsyt.2020.00027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recently, magnetic resonance imaging (MRI) technology has been widely used to quantitatively analyze brain structure, morphology, and functional activities, as well as to clarify the neuropathological and neurobiological mechanisms of schizophrenia. However, although there have been many relevant results and conclusions, there has been no systematic assessment of this field. AIM To analyze important areas of research utilizing MRI in studies of schizophrenia and explore major trends and the knowledge structure using bibliometric analysis. METHODS Literature related to MRI studies of schizophrenia published in PubMed between January 1, 2004 and December 31, 2018 were retrieved in 5-year increments. The extracted major Medical Subject Headings (MeSH) terms/MeSH subheadings were analyzed quantitatively. Bi-clu-stering analysis, social network analysis (SNA), and strategic diagrams were employed to analyze the word matrix and co-occurrence matrix of high-frequency MeSH terms. RESULTS For the periods of 2004 to 2008, 2009 to 2013, and 2014 to 2018, the number of relevant retrieved publications were 916, 1,344, and 1,512 respectively, showing an overall growth trend. 26, 34, and 36 high-frequency major MeSH terms/MeSH subheadings were extracted in each period, respectively. In line with strategic diagrams, the main undeveloped theme clusters in 2004-2008 were effects of antipsychotics on brain structure and their curative efficacy. These themes were replaced in 2009-2013 by physiopathology mechanisms of schizophrenia, etiology of cognitive disorder, research on default mode network and schizophrenic psychology, and were partially replaced in 2014-2018 by studies of differences in the neurobiological basis for schizophrenia and other mental disorders. Based on SNA, nerve net/physiopathology and psychotic disorder/pathology were considered the emerging hotspots of research in 2009-2013 and 2014-2018. CONCLUSIONS MRI studies on schizophrenia were relatively diverse, but the theme clusters derived from each period may reflect the publication trends to some extent. Bibliometric research over a 15-year period may be helpful in depicting the overall scope of research interest and may generate novel ideas for researchers initiating new projects.
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Affiliation(s)
- Li Duan
- Department of Psychiatry, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Gang Zhu
- Department of Psychiatry, the First Affiliated Hospital of China Medical University, Shenyang, China
- Central Laboratory, the First Affiliated Hospital of China Medical University, Shenyang, China
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10
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He H, Luo C, Luo Y, Duan M, Yi Q, Biswal BB, Yao D. Reduction in gray matter of cerebellum in schizophrenia and its influence on static and dynamic connectivity. Hum Brain Mapp 2019; 40:517-528. [PMID: 30240503 PMCID: PMC6865738 DOI: 10.1002/hbm.24391] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/14/2022] Open
Abstract
Pathophysiological and atrophic changes in the cerebellum have been well-documented in schizophrenia. Reduction of gray matter (GM) in the cerebellum was confirmed across cognitive and motor cerebellar modules in schizophrenia. Such abnormalities in the cerebellum could potentially have widespread effects on both sensorimotor and cognitive symptoms. In this study, we investigated how reduction change in the cerebellum affects the static and the dynamic functional connectivity (FC) between the cerebellum and cortical/subcortical networks in schizophrenia. Reduction of GM in the cerebellum was confirmed across the cognitive and motor cerebellar modules in schizophrenic subjects. Results from this study demonstrates that the extent of reduction of GM within cerebellum correlated with increased static FCs between the cerebellum and the cortical/subcortical networks, including frontoparietal network (FPN), and thalamus in patients with schizophrenia. Decreased GM in the cerebellum was also associated with a declined dynamic FC between the cerebellum and the FPN in schizophrenic subjects. The severity of patients' positive symptom was related to these structural-functional coupling score of cerebellum. These findings identified potential cerebellar driven functional changes associated with positive symptom deficits. A post hoc analysis exploring the effect of changed FC within cerebellum, confirmed that a significant positive relationship, between dynamic FCs of cerebellum-thalamus and intracerebellum existed in patients, but not in controls. The reduction of GM within the cerebellum might be associated with modulation of cerebellum-thalamus, and contributes to the dysfunctional cerebellar-cortical communication in schizophrenia. Our results provide a new insight into the role of cerebellum in understanding the pathophysiological of schizophrenia.
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Affiliation(s)
- Hui He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Yuling Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Mingjun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
| | - Qizhong Yi
- Psychological Medicine CenterThe First Affiliated Hospital of Xinjiang Medical UniversityXinjiangPeople's Republic of China
| | - Bharat B. Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
- Department of Biomedical EngineeringNew Jersey Institute of TechnologyNewarkNJ07102USA
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduPeople's Republic of China
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11
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Cerebellar volume and cerebellocerebral structural covariance in schizophrenia: a multisite mega-analysis of 983 patients and 1349 healthy controls. Mol Psychiatry 2018; 23:1512-1520. [PMID: 28507318 DOI: 10.1038/mp.2017.106] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 02/20/2017] [Accepted: 04/04/2017] [Indexed: 12/24/2022]
Abstract
Although cerebellar involvement across a wide range of cognitive and neuropsychiatric phenotypes is increasingly being recognized, previous large-scale studies in schizophrenia (SZ) have primarily focused on supratentorial structures. Hence, the across-sample reproducibility, regional distribution, associations with cerebrocortical morphology and effect sizes of cerebellar relative to cerebral morphological differences in SZ are unknown. We addressed these questions in 983 patients with SZ spectrum disorders and 1349 healthy controls (HCs) from 14 international samples, using state-of-the-art image analysis pipelines optimized for both the cerebellum and the cerebrum. Results showed that total cerebellar grey matter volume was robustly reduced in SZ relative to HCs (Cohens's d=-0.35), with the strongest effects in cerebellar regions showing functional connectivity with frontoparietal cortices (d=-0.40). Effect sizes for cerebellar volumes were similar to the most consistently reported cerebral structural changes in SZ (e.g., hippocampus volume and frontotemporal cortical thickness), and were highly consistent across samples. Within groups, we further observed positive correlations between cerebellar volume and cerebral cortical thickness in frontotemporal regions (i.e., overlapping with areas that also showed reductions in SZ). This cerebellocerebral structural covariance was strongest in SZ, suggesting common underlying disease processes jointly affecting the cerebellum and the cerebrum. Finally, cerebellar volume reduction in SZ was highly consistent across the included age span (16-66 years) and present already in the youngest patients, a finding that is more consistent with neurodevelopmental than neurodegenerative etiology. Taken together, these novel findings establish the cerebellum as a key node in the distributed brain networks underlying SZ.
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Abstract
SummaryThis article summarises new research, together with core features, course
and outcome of schizophrenia with onset in childhood and adolescence, and
investigates its neurobiology and continuity into adult life. It concludes
that, in conformity with other disorders of childhood, adult-based
diagnostic criteria have validity in adolescence. Sadly, the disorder has a
poorer outcome when onset is in youth.
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13
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Romero JE, Coupé P, Giraud R, Ta VT, Fonov V, Park MTM, Chakravarty MM, Voineskos AN, Manjón JV. CERES: A new cerebellum lobule segmentation method. Neuroimage 2017; 147:916-924. [DOI: 10.1016/j.neuroimage.2016.11.003] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 11/04/2016] [Indexed: 01/18/2023] Open
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Cobia DJ, Smith MJ, Salinas I, Ng C, Gado M, Csernansky JG, Wang L. Progressive deterioration of thalamic nuclei relates to cortical network decline in schizophrenia. Schizophr Res 2017; 180:21-27. [PMID: 27613507 PMCID: PMC5263051 DOI: 10.1016/j.schres.2016.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/03/2016] [Accepted: 08/05/2016] [Indexed: 01/28/2023]
Abstract
Thalamic abnormalities are considered part of the complex pathophysiology of schizophrenia, particularly the involvement of specific thalamic nuclei. The goals of this study were to: introduce a novel atlas-based parcellation scheme for defining various thalamic nuclei; compare their integrity in a schizophrenia sample against healthy individuals at baseline and follow-up time points, as well as rates of change over time; examine relationships between the nuclei and abnormalities in known connected cortical regions; and finally, to determine if schizophrenia-related thalamic nuclei changes relate to cognitive functioning and clinical symptoms. Subjects were from a larger longitudinal 2-year follow-up study, schizophrenia (n=20) and healthy individuals (n=20) were group-matched for age, gender, and recent-alcohol use. We used high-dimensional brain mapping to obtain thalamic morphology, and applied a novel atlas-based method for delineating anterior, mediodorsal, and pulvinar nuclei. Results from cross sectional GLMs revealed group differences in bilateral mediodorsal and anterior nuclei, while longitudinal models revealed significant group-by-time interactions for the mediodorsal and pulvinar nuclei. Cortical correlations were the strongest for the pulvinar in frontal, temporal and parietal regions, followed by the mediodorsal nucleus in frontal regions, but none in the anterior nucleus. Thalamic measures did not correlate with cognitive and clinical scores at any time point or longitudinally. Overall, findings revealed a pattern of persistent progressive abnormalities in thalamic nuclei that relate to advancing cortical decline in schizophrenia, but not with measures of behavior.
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Affiliation(s)
- Derin J. Cobia
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E. Ontario, Suite 7-100, Chicago, IL 60611 USA
| | - Matthew J. Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E. Ontario, Suite 7-100, Chicago, IL 60611 USA
| | - Ilse Salinas
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E. Ontario, Suite 7-100, Chicago, IL 60611 USA
| | - Charlene Ng
- Virginia Commonwealth University, Chesterfield Family Practice Center, 2500 Pocoshock Place, Suite 202, Richmond, VA 23235 USA
| | - Mohktar Gado
- Department of Radiology, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110 USA
| | - John G. Csernansky
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E. Ontario, Suite 7-100, Chicago, IL 60611 USA
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E. Ontario, Suite 7-100, Chicago, IL 60611 USA,Department of Radiology, Northwestern University Feinberg School of Medicine, 446 E. Ontario, Suite 7-100, Chicago, IL 60611 USA
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15
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Fraguas D, Díaz-Caneja CM, Pina-Camacho L, Janssen J, Arango C. Progressive brain changes in children and adolescents with early-onset psychosis: A meta-analysis of longitudinal MRI studies. Schizophr Res 2016; 173:132-139. [PMID: 25556081 DOI: 10.1016/j.schres.2014.12.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies on longitudinal brain volume changes in patients with early-onset psychosis (EOP) are particularly valuable for understanding the neurobiological basis of brain abnormalities associated with psychosis. However, findings have not been consistent across studies in this population. We aimed to conduct a meta-analysis on progressive brain volume changes in children and adolescents with EOP. METHODS A systematic literature search of magnetic resonance imaging (MRI) studies comparing longitudinal brain volume changes in children and adolescents with EOP and healthy controls was conducted. The annualized rates of relative change in brain volume by region of interest (ROI) were used as raw data for the meta-analysis. The effect of age, sex, duration of illness, and specific diagnosis on volume change was also evaluated. RESULTS Five original studies with 156 EOP patients (mean age at baseline MRI in the five studies ranged from 13.3 to 16.6years, 67.31% males) and 163 age- and sex-matched healthy controls, with a mean duration of follow-up of 2.46years (range 2.02-3.40), were included. Frontal gray matter (GM) was the only region in which significant differences in volume change over time were found between patients and controls (Hedges' g -0.435, 95% confidence interval (CI): -0.678 to -0.193, p<0.001). Younger age at baseline MRI was associated with greater loss of temporal GM volume over time in patients as compared with controls (p=0.005). Within patients, a diagnosis of schizophrenia was related to greater occipital GM volume loss over time (p=0.001). CONCLUSIONS Compared with healthy individuals, EOP patients show greater progressive frontal GM loss over the first few years after illness onset. Age at baseline MRI and diagnosis of schizophrenia appear to be significant moderators of particular specific brain volume changes.
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Affiliation(s)
- David Fraguas
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Laura Pina-Camacho
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Joost Janssen
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.
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16
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Patients with first-episode, drug-naive schizophrenia and subjects at ultra-high risk of psychosis shared increased cerebellar-default mode network connectivity at rest. Sci Rep 2016; 6:26124. [PMID: 27188233 PMCID: PMC4870637 DOI: 10.1038/srep26124] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/27/2016] [Indexed: 01/06/2023] Open
Abstract
Increased cerebellar-default mode network (DMN) connectivity has been observed in first-episode, drug-naive patients with schizophrenia. However, it remains unclear whether increased cerebellar-DMN connectivity starts earlier than disease onset. Thirty-four ultra-high risk (UHR) subjects, 31 first-episode, drug-naive patients with schizophrenia and 37 healthy controls were enrolled for a resting-state scan. The imaging data were analyzed using the seed-based functional connectivity (FC) method. Compared with the controls, UHR subjects and patients with schizophrenia shared increased connectivity between the right Crus I and bilateral posterior cingulate cortex/precuneus and between Lobule IX and the left superior medial prefrontal cortex. There are positive correlations between the right Crus I-bilateral precuneus connectivity and clinical variables (Structured Interview for Prodromal Syndromes/Positive and Negative Symptom Scale negative symptoms/total scores) in the UHR subjects. Increased cerebellar-DMN connectivity shared by the UHR subjects and the patients not only highlights the importance of the DMN in the pathophysiology of psychosis but also may be a trait alteration for psychosis.
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17
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Guo W, Liu F, Zhang Z, Liu G, Liu J, Yu L, Xiao C, Zhao J. Increased Cerebellar Functional Connectivity With the Default-Mode Network in Unaffected Siblings of Schizophrenia Patients at Rest. Schizophr Bull 2015; 41:1317-25. [PMID: 25956897 PMCID: PMC4601712 DOI: 10.1093/schbul/sbv062] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The default-mode network (DMN) is vital in the neurobiology of schizophrenia, and the cerebellum participates in the high-order cognitive network such as the DMN. However, the specific contribution of the cerebellum to the DMN abnormalities remains unclear in unaffected siblings of schizophrenia patients. Forty-six unaffected siblings of schizophrenia patients and 46 healthy controls were recruited for a resting-state scan. The images were analyzed using the functional connectivity (FC) method. The siblings showed significantly increased FCs between the left Crus I and the left superior medial prefrontal cortex (MPFC), as well as between the lobule IX and the bilateral MPFC (orbital part) and right superior MPFC compared with the controls. No significantly decreased FC was observed in the siblings relative to the controls. The analyses were replicated in 49 first-episode, drug-naive patients with schizophrenia, and the results showed that the siblings and the patients shared increased FCs between the left Crus I and the left superior MPFC, as well as between the lobule IX and the left MPFC (orbital part) compared with the controls. These findings suggest that increased cerebellar-DMN connectivities emerge earlier than illness onset, which highlight the contribution of the cerebellum to the DMN alterations in unaffected siblings. The shared increased cerebellar-DMN connectivities between the patients and the siblings may be used as candidate endophenotypes for schizophrenia.
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Affiliation(s)
- Wenbin Guo
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, China;
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Zhikun Zhang
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Guiying Liu
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Jianrong Liu
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Liuyu Yu
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Changqing Xiao
- Mental Health Center, the First Affiliated Hospital, Guangxi Medical University; Nanning, Guangxi 530021, China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011, China
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18
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Rapado-Castro M, Bartholomeusz CF, Castro-Fornieles J, González-Pinto A, Otero S, Baeza I, Moreno C, Graell M, Janssen J, Bargalló N, Pantelis C, Desco M, Arango C. Gender effects on brain changes in early-onset psychosis. Eur Child Adolesc Psychiatry 2015; 24:1193-205. [PMID: 25589436 DOI: 10.1007/s00787-014-0669-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/18/2014] [Indexed: 11/24/2022]
Abstract
Progressive loss of cortical gray matter (GM) and increase of cerebrospinal fluid (CSF) have been reported in early-onset psychosis (EOP). EOP typically begins during adolescence, a time when developmental brain trajectories differ by gender. This study aimed to determine gender differences in progression of brain changes in this population. A sample of 61 (21 females) adolescents with a first psychotic episode and a matched sample of 70 (23 females) controls underwent both baseline and 2-year follow-up anatomical brain imaging assessments. Regional GM and CSF volumes were obtained using automated methods based on the Talairach's proportional grid system. At baseline, only male patients showed a clear pattern of alterations in the frontal lobe relative to controls (smaller GM and larger CSF volumes). However, parallel longitudinal changes for male and female patients relative to controls were observed, resulting in a common pattern of brain changes across both genders: rate of left frontal lobe GM volume loss was larger in male (-3.8%) and female patients (-4.2%) than in controls (-0.7% males; -0.4% females). The reverse was found for the CSF volume in the left frontal lobe. While the GM and CSF volumes of females with EOP appear to be within the normal range at initial illness onset, our results point to a similar trajectory of increased/accelerated brain changes in both male and female patients with EOP. The pattern of progression of brain changes in psychosis appears to be independent of gender or structural alterations on appearance of psychotic symptoms.
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Affiliation(s)
- Marta Rapado-Castro
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain.
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia.
| | - Cali F Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia
| | - Josefina Castro-Fornieles
- Child Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic de Barcelona, IDIBAPS, SGR-1119, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Ana González-Pinto
- Hospital Santiago Apóstol de Vitoria, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Kronikgune, EHU-UPV, Vitoria, Spain
| | - Soraya Otero
- Child Psychiatry Unit, Hospital Universitario Marqués de Valdecilla, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santander, Spain
| | - Inmaculada Baeza
- Child Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic de Barcelona, IDIBAPS, SGR-1119, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Carmen Moreno
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Montserrat Graell
- Psychiatry and Psychology Department, Hospital Infantil Universitario Niño Jesús, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Joost Janssen
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
- Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Nuria Bargalló
- Image Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia
| | - Manuel Desco
- Department of Bioengineering and Aerospatial Engineering, University Carlos III de Madrid, Madrid, Spain
- Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
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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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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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21
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Epstein KA, Kumra S. White matter fractional anisotropy over two time points in early onset schizophrenia and adolescent cannabis use disorder: A naturalistic diffusion tensor imaging study. Psychiatry Res 2015; 232:34-41. [PMID: 25779033 DOI: 10.1016/j.pscychresns.2014.10.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/15/2014] [Accepted: 10/12/2014] [Indexed: 12/18/2022]
Abstract
Recurrent exposure to cannabis in adolescence increases the risk for later development of psychosis, but there are sparse data regarding the impact of cannabis use on brain structure during adolescence. This pilot study investigated the effect of cannabis use disorder (CUD) upon white matter fractional anisotropy (WM FA) values in non-psychotic treatment-seeking adolescents relative to adolescents with early onset schizophrenia-spectrum disorders (EOSS) and to healthy control (HC) participants. Diffusion tensor imaging (DTI) and tractography methods were used to examine fractional anisotropy (FA) of the cingulum bundle, superior longitudinal fasciculus (SLF), corticospinal tract (CST), inferior longitudinal fasciculus (ILF), inferior fronto-occipital fasciculus (IFOF) and uncinate fasciculus in adolescents with EOSS (n=34), CUD (n=19) and HC (n=29). Participants received DTI and substance use assessments at baseline and at 18-month follow-up. Using multivariate analysis of variance, a significant main effect of diagnostic group was observed. Post-hoc testing revealed that adolescents with CUD showed an altered change in FA values in the left ILF and in the left IFOF (trend level) compared with HC adolescents. Greater consumption of cannabis during the inter-scan interval predicted a greater decrease in left ILF FA in CUD. These preliminary longitudinal data suggest that heavy cannabis use during adolescence, or some factor associated with cannabis use, is associated with an altered change in WM FA values in a fiber bundle that has been implicated in the pathophysiology of EOSS (i.e., the left ILF). Additional studies are needed to clarify the clinical significance of these findings.
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Affiliation(s)
- Katherine A Epstein
- Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Sanjiv Kumra
- Division of Child and Adolescent Psychiatry, University of Minnesota, Minneapolis, MN, USA.
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22
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Laidi C, d’Albis MA, Wessa M, Linke J, Phillips M, Delavest M, Bellivier F, Versace A, Almeida J, Sarrazin S, Poupon C, Le Dudal K, Daban C, Hamdani N, Leboyer M, Houenou J. Cerebellar volume in schizophrenia and bipolar I disorder with and without psychotic features. Acta Psychiatr Scand 2015; 131:223-33. [PMID: 25430729 PMCID: PMC4329064 DOI: 10.1111/acps.12363] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVE There is growing evidence that cerebellum plays a crucial role in cognition and emotional regulation. Cerebellum is likely to be involved in the physiopathology of both bipolar disorder and schizophrenia. The objective of our study was to compare cerebellar size between patients with bipolar disorder, patients with schizophrenia, and healthy controls in a multicenter sample. In addition, we studied the influence of psychotic features on cerebellar size in patients with bipolar disorder. METHOD One hundred and fifteen patients with bipolar I disorder, 32 patients with schizophrenia, and 52 healthy controls underwent 3 Tesla MRI. Automated segmentation of cerebellum was performed using FreeSurfer software. Volumes of cerebellar cortex and white matter were extracted. Analyses of covariance were conducted, and age, sex, and intracranial volume were considered as covariates. RESULTS Bilateral cerebellar cortical volumes were smaller in patients with schizophrenia compared with patients with bipolar I disorder and healthy controls. We found no significant difference of cerebellar volume between bipolar patients with and without psychotic features. No change was evidenced in white matter. CONCLUSION Our results suggest that reduction in cerebellar cortical volume is specific to schizophrenia. Cerebellar dysfunction in bipolar disorder, if present, appears to be more subtle than a reduction in cerebellar volume.
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Affiliation(s)
- Charles Laidi
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatrie, Créteil, France,INSERM, U955, IMRB, Psychiatrie Génétique, Créteil, France,Faculté de médecine, Université Paris Est, Créteil, France,Fondation Fondamental, Créteil, France,UNIACT, Neurospin, I2BM, CEA Saclay, Gif sur Yvette, France
| | - Marc-Antoine d’Albis
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatrie, Créteil, France,INSERM, U955, IMRB, Psychiatrie Génétique, Créteil, France,Faculté de médecine, Université Paris Est, Créteil, France,Fondation Fondamental, Créteil, France,UNIACT, Neurospin, I2BM, CEA Saclay, Gif sur Yvette, France
| | - Michèle Wessa
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Center For Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Julia Linke
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Center For Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Mary Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Marine Delavest
- Fondation Fondamental, Créteil, France,AP-HP, Groupe Saint-Louis, Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - Frank Bellivier
- Fondation Fondamental, Créteil, France,AP-HP, Groupe Saint-Louis, Lariboisière-Fernand Widal, Pôle Neurosciences, Paris, France
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jorge Almeida
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Samuel Sarrazin
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatrie, Créteil, France,INSERM, U955, IMRB, Psychiatrie Génétique, Créteil, France,Faculté de médecine, Université Paris Est, Créteil, France,Fondation Fondamental, Créteil, France,UNIACT, Neurospin, I2BM, CEA Saclay, Gif sur Yvette, France
| | - Cyril Poupon
- UNIRS, Neurospin, I2BM, CEA Saclay, Gif-Sur-Yvette, France
| | - Katia Le Dudal
- Centre d’Investigation Clinique 1430 et Plateforme de Ressources Biologiques, Hôpital Henri Mondor, Créteil, France
| | - Claire Daban
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatrie, Créteil, France,INSERM, U955, IMRB, Psychiatrie Génétique, Créteil, France,Fondation Fondamental, Créteil, France
| | - Nora Hamdani
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatrie, Créteil, France,INSERM, U955, IMRB, Psychiatrie Génétique, Créteil, France,Fondation Fondamental, Créteil, France
| | - Marion Leboyer
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatrie, Créteil, France,INSERM, U955, IMRB, Psychiatrie Génétique, Créteil, France,Faculté de médecine, Université Paris Est, Créteil, France,Fondation Fondamental, Créteil, France
| | - Josselin Houenou
- AP-HP, Hôpital H. Mondor - A. Chenevier, Pôle de Psychiatrie, Créteil, France,INSERM, U955, IMRB, Psychiatrie Génétique, Créteil, France,Fondation Fondamental, Créteil, France,UNIACT, Neurospin, I2BM, CEA Saclay, Gif sur Yvette, France,*Corresponding author: Josselin Houenou, MD, PhD, INSERM U955, Pôle de psychiatrie, Hôpitaux Universitaires Mondor, 40 rue de Mesly 94000 Créteil France, Phone: +33 1 49 81 30 51, Fax: +33 1 49 81 30 59,
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Derivation of high-resolution MRI atlases of the human cerebellum at 3T and segmentation using multiple automatically generated templates. Neuroimage 2014; 95:217-31. [DOI: 10.1016/j.neuroimage.2014.03.037] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/25/2014] [Accepted: 03/12/2014] [Indexed: 01/18/2023] Open
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24
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Bernard JA, Mittal VA. Cerebellar-motor dysfunction in schizophrenia and psychosis-risk: the importance of regional cerebellar analysis approaches. Front Psychiatry 2014; 5:160. [PMID: 25505424 PMCID: PMC4243486 DOI: 10.3389/fpsyt.2014.00160] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/25/2014] [Indexed: 12/21/2022] Open
Abstract
Motor abnormalities in individuals with schizophrenia and those at-risk for psychosis are well documented. An accumulating body of work has also highlighted motor abnormalities related to cerebellar dysfunction in schizophrenia including eye-blink conditioning, timing, postural control, and motor learning. We have also recently found evidence for motor dysfunction in individuals at ultra high-risk for psychosis (1-3). This is particularly relevant as the cerebellum is thought to be central to the cognitive dysmetria model of schizophrenia, and these overt motor signs may point to more general cerebellar dysfunction in the etiology of psychotic disorders. While studies have provided evidence indicative of motor cerebellar dysfunction in at-risk populations and in schizophrenia, findings with respect to the cerebellum have been mixed. One factor potentially contributing to these mixed results is the whole-structure approach taken when investigating the cerebellum. In non-human primates, there are distinct closed-loop circuits between the cerebellum, thalamus, and brain with motor and non-motor cortical regions. Recent human neuroimaging has supported this finding and indicates that there is a cerebellar functional topography (4), and this information is being missed with whole-structure approaches. Here, we review cerebellar-motor dysfunction in individuals with schizophrenia and those at-risk for psychosis. We also discuss cerebellar abnormalities in psychosis, and the cerebellar functional topography. Because of the segregated functional regions of the cerebellum, we propose that it is important to look at the structure regionally in order to better understand its role in motor dysfunction in these populations. This is analogous to approaches taken with the basal ganglia, where each region is considered separately. Such an approach is necessary to better understand cerebellar pathophysiology on a macro-structural level with respect to the pathogenesis of psychosis.
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Affiliation(s)
- Jessica A Bernard
- Department of Psychology and Neuroscience, University of Colorado Boulder , Boulder, CO , USA
| | - Vijay A Mittal
- Department of Psychology and Neuroscience, University of Colorado Boulder , Boulder, CO , USA ; Center for Neuroscience, University of Colorado Boulder , Boulder, CO , USA
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25
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Ellegood J, Markx S, Lerch J, Steadman P, Genç C, Provenzano F, Kushner S, Henkelman R, Karayiorgou M, Gogos J. Neuroanatomical phenotypes in a mouse model of the 22q11.2 microdeletion. Mol Psychiatry 2014; 19:99-107. [PMID: 23999526 PMCID: PMC3872255 DOI: 10.1038/mp.2013.112] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 07/21/2013] [Accepted: 07/22/2013] [Indexed: 12/21/2022]
Abstract
Recurrent deletions at the 22q11.2 locus have been established as a strong genetic risk factor for the development of schizophrenia and cognitive dysfunction. Individuals with 22q11.2 deletions have a range of well-defined volumetric abnormalities in a number of critical brain structures. A mouse model of the 22q11.2 deletion (Df(16)A(+/-)) has previously been utilized to characterize disease-associated abnormalities on synaptic, cellular, neurocircuitry, and behavioral levels. We performed a high-resolution MRI analysis of mutant mice compared with wild-type littermates. Our analysis revealed a striking similarity in the specific volumetric changes of Df(16)A(+/-) mice compared with human 22q11.2 deletion carriers, including in cortico-cerebellar, cortico-striatal and cortico-limbic circuits. In addition, higher resolution magnetic resonance imaging compared with neuroimaging in human subjects allowed the detection of previously unknown subtle local differences. The cerebellar findings in Df(16)A(+/-) mice are particularly instructive as they are localized to specific areas within both the deep cerebellar nuclei and the cerebellar cortex. Our study indicates that the Df(16)A(+/-)mouse model recapitulates most of the hallmark neuroanatomical changes observed in 22q11.2 deletion carriers. Our findings will help guide the design and interpretation of additional complementary studies and thereby advance our understanding of the abnormal brain development underlying the emergence of 22q11.2 deletion-associated psychiatric and cognitive symptoms.
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Affiliation(s)
- J. Ellegood
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada
| | - S. Markx
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - J.P. Lerch
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada
,Department of Medical Biophysics, University of Toronto, Toronto, Ontario Canada
| | - P.E. Steadman
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada
,Department of Medical Biophysics, University of Toronto, Toronto, Ontario Canada
| | - C. Genç
- Department of Psychiatry, Erasmus Medical Center, The Netherlands
| | - F Provenzano
- Department of Department of Biomedical Engineering, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - S.A. Kushner
- Department of Psychiatry, Erasmus Medical Center, The Netherlands
| | - R.M. Henkelman
- Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada
,Department of Medical Biophysics, University of Toronto, Toronto, Ontario Canada
| | - M. Karayiorgou
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - J.A. Gogos
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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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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27
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Fusar-Poli P, Smieskova R, Kempton MJ, Ho BC, Andreasen NC, Borgwardt S. Progressive brain changes in schizophrenia related to antipsychotic treatment? A meta-analysis of longitudinal MRI studies. Neurosci Biobehav Rev 2013; 37:1680-91. [PMID: 23769814 PMCID: PMC3964856 DOI: 10.1016/j.neubiorev.2013.06.001] [Citation(s) in RCA: 360] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 12/15/2022]
Abstract
Context Antipsychotic treatment is the first-line treatment option for schizophrenia. Individual studies suggested they can significantly affect brain structure and account for progressive brain changes observed during the illness. Objectives To quantitatively examine the effect of antipsychotics as compared to illness related factors on progressive brain changes in schizophrenia. Data sources Electronic databases were searched until April 2012. All magnetic resonance imaging studies reporting progressive brain changes in schizophrenia subjects and antipsychotic exposure were retrieved. Study selection 30 longitudinal MRI studies with antipsychotic administration in schizophrenia patients met the inclusion criteria. Data extraction Brain volumes before and after antipsychotic exposure, duration of illness, severity of psychotic symptoms as well as demographic, clinical, and methodological variables were extracted from each publication, or obtained directly from its authors. Data synthesis The overall sample was of 1046 schizophrenia patients and 780 controls for a median duration of follow-up of 72.4 weeks. At baseline, patients showed significant whole brain volume reductions and enlarged lateral ventricle (LV) volumes compared to controls. No baseline volumetric abnormalities were detected in the gray matter volumes (GMV), white matter volumes, cerebrospinal fluid and caudate nucleus. Longitudinally, there were progressive GMV decreases and LV enlargements in patients but not in controls. The GMV decreases were inversely correlated with cumulative exposure to antipsychotic treatments, while no effects were observed for duration of illness or illness severity. Conclusions Schizophrenia is characterized by progressive gray matter volume decreases and lateral ventricular volume increases. Some of these neuroanatomical alterations may be associated with antipsychotic treatment.
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Affiliation(s)
- P Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, United Kingdom.
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28
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Nosarti C. Structural and functional brain correlates of behavioral outcomes during adolescence. Early Hum Dev 2013; 89:221-7. [PMID: 23477720 DOI: 10.1016/j.earlhumdev.2013.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 02/01/2013] [Indexed: 10/27/2022]
Abstract
Several studies have described an association between very preterm birth and behavioral and psychiatric outcomes in childhood and adolescence. The exact mechanisms underlying this association are unknown, but impaired neurodevelopment has been proposed as a possible etiological factor. Existing research suggests a selective vulnerability of brain regions associated with a variety of behavioral and psychiatric outcomes following very preterm birth. This article reviews studies that have directly explored the structural and functional brain correlates of behavioral outcomes in ex-preterm individuals, with an emphasis on attentional problems, overall mental health functioning including internalizing and externalizing scores, and psychosocial adjustment. The focus here is on neuroimaging research conducted during adolescence, a period of life associated with the emergence and early expression of several psychiatric disorders. The neurodevelopmental hypothesis is used as a theoretical framework, according to which early brain lesions interact with the developing brain to increase later vulnerability to psychopathology.
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Affiliation(s)
- Chiara Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, De Crespigny Park, London, SE5 8AF, UK.
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Gray matter volume in schizophrenia and bipolar disorder with psychotic features. Schizophr Res 2012; 138:177-82. [PMID: 22445668 PMCID: PMC3372612 DOI: 10.1016/j.schres.2012.03.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 02/29/2012] [Accepted: 03/02/2012] [Indexed: 01/09/2023]
Abstract
There is growing evidence that schizophrenia (SZ) and bipolar disorder (BD) overlap significantly in risk factors, neurobiological features, clinical presentations, and outcomes. SZ is characterized by well documented gray matter (GM) abnormalities in multiple frontal, temporal and subcortical structures. Recent voxel-based morphometry (VBM) studies and meta-analyses in BD also report GM reductions in overlapping, albeit less widespread, brain regions. Psychosis, a hallmark of SZ, is also experienced by a significant proportion of BD patients and there is evidence that psychotic BD may be characterized by specific clinical and pathophysiological features. However, there are few studies comparing GM between SZ and psychotic BD. In this study we compared GM volumes in a sample of 58 SZ patients, 28 BD patients experiencing psychotic symptoms and 43 healthy controls using whole-brain voxel-based morphometry. SZ patients had GM reductions in multiple frontal and temporal regions compared to healthy controls and in the subgenual cortex compared to psychotic BD patients. GM volume was increased in the right posterior cerebellum in SZ patients compared to controls. However, psychotic BD patients did not show significant GM deficits compared to healthy controls or SZ patients. We conclude that GM abnormality as measured by VBM analysis is less pronounced in psychotic BD compared to SZ. This may be due to disease-specific factors or medications used more commonly in BD.
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30
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One year longitudinal study of the straight gyrus morphometry in first-episode schizophrenia-spectrum patients. Psychiatry Res 2012; 202:80-3. [PMID: 22595509 DOI: 10.1016/j.pscychresns.2011.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 07/18/2011] [Accepted: 10/06/2011] [Indexed: 11/22/2022]
Abstract
The aim of this study was to use a region-of-interest approach with magnetic resonance imaging to examine the volume of the straight gyrus volume change in first-episode schizophrenia-spectrum patients compared with healthy subjects over a 1-year follow-up period. We did not find a differential pattern of volumetric change between the two groups.
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Kumra S, Robinson P, Tambyraja R, Jensen D, Schimunek C, Houri A, Reis T, Lim K. Parietal lobe volume deficits in adolescents with schizophrenia and adolescents with cannabis use disorders. J Am Acad Child Adolesc Psychiatry 2012; 51:171-80. [PMID: 22265363 DOI: 10.1016/j.jaac.2011.11.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 09/22/2011] [Accepted: 11/01/2011] [Indexed: 02/03/2023]
Abstract
OBJECTIVE In early-onset schizophrenia (EOS), the earliest structural brain volumetric abnormalities appear in the parietal cortices. Early exposure to cannabis may represent an environmental risk factor for developing schizophrenia. This study characterized cerebral cortical gray matter structure in adolescents in regions of interest (ROIs) that have been implicated in EOS and cannabis use disorders (CUD). METHOD T1-weighted magnetic resonance images were acquired from adolescents with EOS (n = 35), CUD (n = 16), EOS + CUD (n = 13), and healthy controls (HC) (n = 51). Using FreeSurfer, brain volume was examined within frontal, temporal, parietal and subcortical ROIs by a 2 (EOS versus no EOS) × 2 (CUD versus no CUD) design using multivariate analysis of covariance. In ROIs in which volumetric differences were identified, additional analyses of cortical thickness and surface area were conducted. RESULTS A significant EOS-by-CUD interaction was observed. In the left superior parietal region, both "pure" EOS and "pure" CUD had smaller gray matter volumes that were associated with lower surface area compared with HC. A similar alteration was observed in the comorbid group compared with HC, but there was no additive volumetric deficit found in the comorbid group compared with the separate groups. In the left thalamus, the comorbid group had smaller gray matter volumes compared with the CUD and HC groups. CONCLUSIONS These preliminary data indicate that the presence of a CUD may moderate the relationship between EOS and cerebral cortical gray matter structure in the left superior parietal lobe. Future research will follow this cohort over adolescence to further examine the impact of cannabis use on neurodevelopment.
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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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Reig S, Parellada M, Castro-Fornieles J, Janssen J, Moreno D, Baeza I, Bargalló N, González-Pinto A, Graell M, Ortuño F, Otero S, Arango C, Desco M. Multicenter study of brain volume abnormalities in children and adolescent-onset psychosis. Schizophr Bull 2011; 37:1270-80. [PMID: 20478821 PMCID: PMC3196940 DOI: 10.1093/schbul/sbq044] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The goal of the study is to determine the extent of structural brain abnormalities in a multicenter sample of children and adolescents with a recent-onset first episode of psychosis (FEP), compared with a sample of healthy controls. Total brain and lobar volumes and those of gray matter (GM), white matter, and cerebrospinal fluid (CSF) were measured in 92 patients with a FEP and in 94 controls, matched for age, gender, and years of education. Male patients (n = 64) showed several significant differences when compared with controls (n = 61). GM volume in male patients was reduced in the whole brain and in frontal and parietal lobes compared with controls. Total CSF volume and frontal, temporal, and right parietal CSF volumes were also increased in male patients. Within patients, those with a further diagnosis of "schizophrenia" or "other psychosis" showed a pattern similar to the group of all patients relative to controls. However, bipolar patients showed fewer differences relative to controls. In female patients, only the schizophrenia group showed differences relative to controls, in frontal CSF. GM deficit in male patients with a first episode correlated with negative symptoms. Our study suggests that at least part of the GM deficit in children and adolescent-onset schizophrenia and in other psychosis occurs before onset of the first positive symptoms and that, contrary to what has been shown in children-onset schizophrenia, frontal GM deficits are probably present from the first appearance of positive symptoms in children and adolescents.
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Affiliation(s)
- Santiago Reig
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain,To whom correspondence should be addressed; tel: +34-91-586-6678, fax: +34-91-426-5108; e-mail:
| | - Mara Parellada
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josefina Castro-Fornieles
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Universidad de Barcelona, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi I Sunyer), Hospital Clínic Universitari de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Joost Janssen
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Dolores Moreno
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Inmaculada Baeza
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Institut de Neurociències, Hospital Clínic i Universitari, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Nuria Bargalló
- Departamento de Radiología, Centro de Diagnóstico por la Imagen, Hospital Clínico, Barcelona, Spain
| | - Ana González-Pinto
- Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Vitoria, Spain
| | - Montserrat Graell
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Felipe Ortuño
- Departamento de Psiquiatría y Psicología Médica, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - Soraya Otero
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santander, Cantabria, Spain
| | - Celso Arango
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Manuel Desco
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Shah N, Nakamura Y. Case Report: Schizophrenia Discovered during the Patient Interview in a Man with Shoulder Pain Referred for Physical Therapy. Physiother Can 2011; 62:308-15. [PMID: 21886370 DOI: 10.3138/physio.62.4.308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this case report is to demonstrate the importance of a thorough patient interview. The case involves a man referred for physical therapy for a musculoskeletal dysfunction; during the patient interview, a psychiatric disorder was recognized that was later identified as schizophrenia. A secondary purpose is to educate physical therapists on the recognizable signs and symptoms of schizophrenia.Client description: A 19-year-old male patient with chronic shoulder, elbow, and wrist pain was referred for physical therapy. During the interview, the patient reported that he was receiving signals from an electronic device implanted in his body.Measures and outcome: The physical therapist's initial assessment identified a disorder requiring medical referral. Further management of the patient's musculoskeletal dysfunction was not appropriate at this time. INTERVENTION The patient was referred for further medical investigation, as he was demonstrating signs suggestive of a psychiatric disorder. The patient was diagnosed with schizophrenia by a psychiatrist and was prescribed Risperdal. IMPLICATIONS This case study reinforces the importance of a thorough patient interview by physical therapists to rule out non-musculoskeletal disorders. Patients seeking neuromusculoskeletal assessment and treatment may have undiagnosed primary or secondary psychiatric disorders that require recognition by physical therapists and possible medical referral.
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Affiliation(s)
- Nirtal Shah
- Nirtal Shah, PT, MSc, DPT, MTC, FAAOMPT, FCAMT, CAFCI: Physical therapist, David L. MacIntosh Sport Medicine Clinic, University of Toronto, Toronto, Ontario
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Olabi B, Ellison-Wright I, McIntosh AM, Wood SJ, Bullmore E, Lawrie SM. Are there progressive brain changes in schizophrenia? A meta-analysis of structural magnetic resonance imaging studies. Biol Psychiatry 2011; 70:88-96. [PMID: 21457946 DOI: 10.1016/j.biopsych.2011.01.032] [Citation(s) in RCA: 352] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 01/21/2011] [Accepted: 01/22/2011] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is well established that schizophrenia is associated with structural brain abnormalities, but whether these are static or progress over time remains controversial. METHODS A systematic review of longitudinal volumetric studies using region-of-interest structural magnetic resonance imaging in patients with schizophrenia and healthy control subjects. The percentage change in volume between scans for each brain region of interest was obtained, and data were combined using random effects meta-analysis. RESULTS Twenty-seven studies were included in the meta-analysis, with 928 patients and 867 control subjects, and 32 different brain regions of interest. Subjects with schizophrenia showed significantly greater decreases over time in whole brain volume, whole brain gray matter, frontal gray and white matter, parietal white matter, and temporal white matter volume, as well as larger increases in lateral ventricular volume, than healthy control subjects. The time between baseline and follow-up magnetic resonance imaging scans ranged from 1 to 10 years. The differences between patients and control subjects in annualized percentage volume change were -.07% for whole brain volume, -.59% for whole brain gray matter, -.32% for frontal white matter, -.32% for parietal white matter, -.39% for temporal white matter, and +.36% for bilateral lateral ventricles. CONCLUSIONS These findings suggest that schizophrenia is associated with progressive structural brain abnormalities, affecting both gray and white matter. We found no evidence to suggest progressive medial temporal lobe involvement but did find evidence that this may be partly explained by heterogeneity between studies in patient age and illness duration. The causes and clinical correlates of these progressive brain changes should now be the focus of investigation.
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Affiliation(s)
- Bayanne Olabi
- Division of Psychiatry, School of Molecular and Clinical Medicine, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
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Voineskos AN, Lett TAP, Lerch JP, Tiwari AK, Ameis SH, Rajji TK, Müller DJ, Mulsant BH, Kennedy JL. Neurexin-1 and frontal lobe white matter: an overlapping intermediate phenotype for schizophrenia and autism spectrum disorders. PLoS One 2011; 6:e20982. [PMID: 21687627 PMCID: PMC3110800 DOI: 10.1371/journal.pone.0020982] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 05/14/2011] [Indexed: 01/01/2023] Open
Abstract
Background Structural variation in the neurexin-1 (NRXN1) gene increases risk for both autism spectrum disorders (ASD) and schizophrenia. However, the manner in which NRXN1 gene variation may be related to brain morphology to confer risk for ASD or schizophrenia is unknown. Method/Principal Findings 53 healthy individuals between 18–59 years of age were genotyped at 11 single nucleotide polymorphisms of the NRXN1 gene. All subjects received structural MRI scans, which were processed to determine cortical gray and white matter lobar volumes, and volumes of striatal and thalamic structures. Each subject's sensorimotor function was also assessed. The general linear model was used to calculate the influence of genetic variation on neural and cognitive phenotypes. Finally, in silico analysis was conducted to assess potential functional relevance of any polymorphisms associated with brain measures. A polymorphism located in the 3′ untranslated region of NRXN1 significantly influenced white matter volumes in whole brain and frontal lobes after correcting for total brain volume, age and multiple comparisons. Follow-up in silico analysis revealed that this SNP is a putative microRNA binding site that may be of functional significance in regulating NRXN1 expression. This variant also influenced sensorimotor performance, a neurocognitive function impaired in both ASD and schizophrenia. Conclusions Our findings demonstrate that the NRXN1 gene, a vulnerability gene for SCZ and ASD, influences brain structure and cognitive function susceptible in both disorders. In conjunction with our in silico results, our findings provide evidence for a neural and cognitive susceptibility mechanism by which the NRXN1 gene confers risk for both schizophrenia and ASD.
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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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Nosarti C, Walshe M, Rushe TM, Rifkin L, Wyatt J, Murray RM, Allin MP. Neonatal ultrasound results following very preterm birth predict adolescent behavioral and cognitive outcome. Dev Neuropsychol 2011; 36:118-35. [PMID: 21253994 DOI: 10.1080/87565641.2011.540546] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study investigated the association between different neonatal ultrasonographic classifications and adolescent cognitive, educational, and behavioral outcomes following very preterm birth. Participants included a group of 120 adolescents who were born very preterm (<33 weeks of gestation), subdivided into three groups according to their neonatal cerebral ultrasound (US) classifications: (a) normal (N = 69), (b) periventricular hemorrhage (PVH, N = 37), and (c) PVH with ventricular dilatation (PVH + DIL, N = 14), and 50 controls. The cognitive functions assessed were full-scale IQ, phonological and semantic verbal fluency, and visual-motor integration. Educational outcomes included reading and spelling; behavioral outcomes were assessed with the Rutter Parents' Scale and the Premorbid Adjustment Scale (PAS). Adolescent outcome scores were compared among the four groups. A main effect for group was observed for full-scale IQ, Rutter Parents' Scale total scores, and PAS total scores, after controlling for gestational age, socioeconomic status and gender, with the PVH + DIL group showing the most impaired scores compared to the other groups. The current results demonstrate that routine neonatal ultrasound classifications are associated with later cognitive and behavioral outcome. Neonatal ultrasounds could aid in the identification of subgroups of children who are at increased risk of neurodevelopmental problems. These at risk subgroups could then be referred to appropriate early intervention services.
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Affiliation(s)
- C Nosarti
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK.
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James A, Hough M, James S, Winmill L, Burge L, Nijhawan S, Matthews PM, Zarei M. Greater white and grey matter changes associated with early cannabis use in adolescent-onset schizophrenia (AOS). Schizophr Res 2011; 128:91-7. [PMID: 21388791 DOI: 10.1016/j.schres.2011.02.014] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 02/15/2011] [Accepted: 02/15/2011] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cannabis use is associated with a higher risk of schizophrenia, however, its specific long-term effect on the structure of the brain of adolescent-onset schizophrenic patients remains unclear. AIMS To study cognitive and structural (grey and white matter) changes in patients with adolescent-onset schizophrenia (AOS) with early cannabis use (CAN+ve) (more than 3 times/week for at least 6 months) and without cannabis use (CAN-ve) versus controls. METHOD An optimised voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) MRI study of 32 adolescents with DSM IV schizophrenia-16 CAN+ve and 16 CAN-ve, and 28 healthy adolescents. RESULTS Compared to CAN-ve subjects, CAN+ve subjects showed GM density loss in temporal fusiform gyrus, parahippocampal gyrus, ventral striatum, right middle temporal gyrus, insular cortex, precuneus, right paracingulate gyrus, dorsolateral prefrontal cortex, left postcentral gyrus, lateral occipital cortex and cerebellum. Similar group comparison showed decreased fractional anisotropy (FA) in particular in brain stem, internal capsule, corona radiata, superior and inferior longitudinal fasciculus in CAN+ve patients. No cognitive differences were apparent between CAN+ve and CAN-ve subjects, and both were impaired relative to controls. CONCLUSION Cannabis use in early adolescence increases WM and GM deficits in AOS, but does not appear to increase the cognitive deficit associated with this illness.
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Affiliation(s)
- A James
- Highfield Adolescent Unit, Warneford Hospital, Oxford, United Kingdom.
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Abstract
BACKGROUND People with schizophrenia are often found to have smaller brains and larger brain ventricles than normal, but the role of antipsychotic medication remains unclear. METHOD We conducted a systematic review of magnetic resonance imaging (MRI) studies. We included longitudinal studies of brain changes in patients taking antipsychotic drugs and we examined studies of antipsychotic-naive patients for comparison purposes. RESULTS Fourteen out of 26 longitudinal studies showed a decline in global brain or grey-matter volume or an increase in ventricular or cerebrospinal fluid (CSF) volume during the course of drug treatment, including the largest studies conducted. The frontal lobe was most consistently affected, but overall changes were diffuse. One large study found different degrees of volume loss with different antipsychotics, and another found that volume changes were associated with taking medication compared with taking none. Analyses of linear associations between drug exposure and brain volume changes produced mixed results. Five out of 21 studies of patients who were drug naive, or had only minimal prior treatment, showed some differences from controls in volumes of interest. No global differences were reported in three studies of drug-naive patients with long-term illness. Studies of high-risk groups have not demonstrated differences from controls in global or lobar brain volumes. CONCLUSIONS Some evidence points towards the possibility that antipsychotic drugs reduce the volume of brain matter and increase ventricular or fluid volume. Antipsychotics may contribute to the genesis of some of the abnormalities usually attributed to schizophrenia.
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Affiliation(s)
- J Moncrieff
- Department of Mental Health Sciences, University College London, UK.
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El-Sayed M, Steen RG, Poe MD, Bethea TC, Gerig G, Lieberman J, Sikich L. Brain volumes in psychotic youth with schizophrenia and mood disorders. J Psychiatry Neurosci 2010; 35:229-36. [PMID: 20569649 PMCID: PMC2895153 DOI: 10.1503/jpn.090051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND We sought to test the hypothesis that deficits in grey matter volume are characteristic of psychotic youth with early-onset schizophrenia-spectrum disorders (EOSS) but not of psychotic youth with early-onset mood disorders (EOMD). METHODS We used magnetic resonance imaging to examine brain volume in 24 psychotic youth (13 male, 11 female) with EOSS (n = 12) or EOMD (n = 12) and 17 healthy controls (10 male, 7 female). We measured the volume of grey and white matter using an automated segmentation program. RESULTS After adjustment for age and intracranial volume, whole brain volume was lower in the EOSS patients than in the healthy controls (p = 0.001) and EOMD patients (p = 0.002). The EOSS patients had a deficit in grey matter volume (p = 0.005), especially in the frontal (p = 0.003) and parietal (p = 0.006) lobes, with no significant differences in white matter volume. LIMITATIONS The main limitations of our study were its small sample size and the inclusion of patients with depression and mania in the affective group. CONCLUSION Adolescents with EOSS have grey matter deficits compared with healthy controls and psychotic adolescents with EOMD. Our results suggest that grey matter deficits are not generally associated with psychosis but may be specifically associated with schizophrenia. Larger studies with consistent methods are needed to reconcile the contradictory findings among imaging studies involving psychotic youth.
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Affiliation(s)
| | | | | | | | | | | | - Linmarie Sikich
- Correspondence to: Dr. L. Sikich, Department of Psychiatry, University of North Carolina, Chapel Hill NC 27599-7160; fax 919 966-9646;
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Scorza FA, Schmitt A, Cysneiros RM, Arida RM, Cavalheiro EA, Gattaz WF. Thalamic nuclear abnormalities as a contributory factor in sudden cardiac deaths among patients with schizophrenia. Clinics (Sao Paulo) 2010; 65:539-46. [PMID: 20535373 PMCID: PMC2882549 DOI: 10.1590/s1807-59322010000500012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Revised: 01/31/2010] [Accepted: 02/09/2010] [Indexed: 11/21/2022] Open
Abstract
Patients with schizophrenia have a two- to three-fold increased risk of premature death as compared to patients without this disease. It has been established that patients with schizophrenia are at a high risk of developing cardiovascular disease. Moreover, an important issue that has not yet been explored is a possible existence of a "cerebral" focus that could trigger sudden cardiac death in patients with schizophrenia. Along these lines, several structural and functional alterations in the thalamic complex are evident in patients with schizophrenia and have been correlated with the symptoms manifested by these patients. With regard to abnormalities on the cellular and molecular level, previous studies have shown that schizophrenic patients have fewer neuronal projections from the thalamus to the prefrontal cortex as well as a reduced number of neurons, a reduced volume of either the entire thalamus or its subnuclei, and abnormal glutamate signaling. According to the glutamate hypothesis of schizophrenia, hypofunctional corticostriatal and striatothalamic projections are directly involved in the pathophysiology of the disease. Animal and post-mortem studies have provided a large amount of evidence that links the sudden unexpected death in epilepsy (SUDEP) that occurs in patients with schizophrenia and epilepsy to thalamic changes. Based on the results of these prior studies, it is clear that further research regarding the relationship between the thalamus and sudden cardiac death is of vital importance.
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Affiliation(s)
- Fulvio A. Scorza
- Disciplina de Neurologia Experimental, Universidade Federal de São Paulo (UNIFESP) - São Paulo/SP, Brasil
| | - Andrea Schmitt
- Department of Psychiatry, University of Goettingen - Germany
| | - Roberta M. Cysneiros
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento do Centro de Ciências Biológicas e da Saúde da Universidade Presbiteriana Mackenzie - São Paulo/SP, Brasil
| | - Ricardo M. Arida
- Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP) - São Paulo/SP, Brasil
| | - Esper A. Cavalheiro
- Centro de Cirurgia de Epilepsia (CIREP), Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto/SP, Brasil
| | - Wagner F. Gattaz
- Laboratório de Neurociência (LIM-27), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brasil.,
, Tel: 0049 551 39 10366
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Jepsen JRM, Fagerlund B, Pagsberg AK, Christensen AMR, Hilker RW, Nordentoft M, Mortensen EL. Course of intelligence deficits in early onset, first episode schizophrenia: a controlled, 5-year longitudinal study. Eur Child Adolesc Psychiatry 2010; 19:341-51. [PMID: 19763665 DOI: 10.1007/s00787-009-0053-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Accepted: 08/20/2009] [Indexed: 11/25/2022]
Abstract
Only few prospective longitudinal studies have assessed the course of intelligence deficits in early onset schizophrenia (EOS), and these have used different age appropriate versions of Wechsler Intelligence Scales and age appropriate norms. The post-psychotic development of intelligence in EOS has predominantly been characterized as relatively stable in these studies. However, comparisons of IQs from different test versions based on the different norms may not permit unequivocal interpretations. The objective of the current study was to compare the development of intelligence in EOS patients (N = 10) from their first psychotic episode to 5 years of post onset with that of healthy controls (N = 35) and patients who at baseline had been diagnosed with other non-affective psychoses (N = 8). The same version of a Wechsler Intelligence Scale was administered at both baseline and follow-up assessments, and the same norms were used to derive IQs at baseline and follow-up. Significantly smaller change in mean full scale intelligence quotient (FSIQ) was found in diagnostically stable EOS patients compared with healthy controls during the follow-up period. However, no statistically significant difference in mean FSIQ change was observed between patients with EOS and patients with other non-affective psychoses, although this result must be interpreted with caution due to the small sample sizes. The results suggest abnormally slow acquisition of new intellectual information and skills in EOS patients during the first 5 years after full clinical presentation.
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Abstract
The thalamus plays a critical role in the coordination of information as it passes from region to region within the brain. A disruption of that information flow may give rise to some of the cardinal symptoms of schizophrenia. In support of this hypothesis, schizophrenia-like syndromes emerge when illnesses, such as stroke, selectively damage the thalamus while sparing the rest of the brain. Evidence from many sources has implicated thalamic dysfunction in schizophrenia. In postmortem studies, several subregions of the thalamus, including the mediodorsal nucleus and the pulvinar, have been shown to have fewer neurons in schizophrenia. Neurochemical disturbances are also seen, with changes in both the glutamate and dopamine systems; thalamic glutamate receptor expression is altered in schizophrenia, and dopamine appears to be elevated in thalamic subregions, while evidence exists of an imbalance between dopamine and other neurotransmitters. In vivo studies using magnetic resonance imaging have demonstrated smaller thalamic volumes in schizophrenia, as well as shape deformations suggesting changes in those thalamic regions that are most densely connected to the portions of the brain responsible for executive function and sensory integration. These changes seem to be correlated with clinical symptoms. The thalamus is a starting point for several parallel, overlapping networks that extend from thalamic nuclei to the cortex. Evidence is emerging that changes in the thalamic nodes of these networks are echoed by changes at other points along the chain; this suggests that schizophrenia might be a disease of disrupted thalamocortical neural networks. This model distributes the pathology throughout the network, but also concentrates attention on the thalamus as a critical structure, especially because of its role in coordinating the flow of information within and between neural networks.
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Affiliation(s)
- Will J Cronenwett
- Psychiatry and Behavioral Sciences, Northwestern University, 446 E. Ontario, Suite 7-200, Chicago, IL 60611, USA.
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Janssen J, Reig S, Alemán Y, Schnack H, Udias JM, Parellada M, Graell M, Moreno D, Zabala A, Balaban E, Desco M, Arango C. Gyral and sulcal cortical thinning in adolescents with first episode early-onset psychosis. Biol Psychiatry 2009; 66:1047-54. [PMID: 19717139 DOI: 10.1016/j.biopsych.2009.07.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 07/10/2009] [Accepted: 07/19/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Psychosis is associated with volumetric decreases of cortical structures. Whether these volumetric decreases imply abnormalities in cortical thickness, surface, or cortical folding is not clear. Due to differences in cytoarchitecture, cortical gyri and sulci might be differentially affected by psychosis. Therefore, we examined differences in gyral and sulcal cortical thickness, surface, folding, and volume between a minimally treated male adolescent population with early-onset first-episode psychosis (EOP) and a healthy control group, with surface-based morphometry. METHODS Magnetic resonance imaging brain scans were obtained from 49 adolescent EOP patients and 34 healthy control subjects. Subjects were younger than 18 years (age range 12 years-18 years), and EOP patients had a duration of positive symptoms of <6 months. RESULTS Early-onset first-episode psychosis was associated with local bilateral cortical thinning and volume deficits in both the gyri and sulci of the superior temporal cortex and the inferior, middle, medial, and superior prefrontal cortex. In the pars triangularis and opercularis cortex of patients, gyral cortical thickness was thinner, whereas sulcal thickness was not. Patients exhibited cortical thinning together with a decreased degree of cortical folding in the right superior frontal cortex. CONCLUSIONS Cortical thinning of both gyri and sulci seem to underlie most cortical volume deficits in adolescent patients with EOP. Except for the right superior frontal region, the degree of cortical folding was normal in regions showing decreased cortical thickness, suggesting that the process of cortical thinning in adolescent patients with EOP primarily takes place after the formation of cortical folds.
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Affiliation(s)
- Joost Janssen
- Department of Experimental Medicine and Surgery, Hospital General Universitario Gregorio Marañón, CIBERSAM, Spain.
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Kumra S, Asarnow R, Grace A, Keshavan M, McClellan J, Sikich L, Wagner A. From bench to bedside: translating new research from genetics and neuroimaging into treatment development for early-onset schizophrenia. Early Interv Psychiatry 2009; 3:243-58. [PMID: 22642727 DOI: 10.1111/j.1751-7893.2009.00142.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Children and adolescents with schizophrenia share a similar pattern of phenomenological, genetic and cognitive abnormalities to adults with schizophrenia. However, an early-onset of schizophrenia (EOS) (prior to 18 years of age) is associated with a higher frequency of risk indicators associated with schizophrenia (e.g. developmental delays and familial spectrum disorders) and a worse long-term outcome. This overview examines recent research on the neurobiological alterations, possible causes, developmental trajectory and treatment of EOS and attempts to identify gaps in the field. METHOD The authors provide a selective review of major findings from genetics, neuroimaging and treatment studies of pediatric schizophrenia that were presented at a workshop sponsored by the National Institute of Mental Health. These data are synthesized in conjunction with preclinical studies into a model of the pathophysiology of EOS. RESULTS EOS is associated with a high frequency of cytogenetic abnormalities (e.g. velocardiofacial syndrome, sex chromosome anomalies) and other rare denovo chromosomal aberrations. Brain imaging research in adolescents with EOS has revealed a progressive loss of cortical grey matter post-onset of psychosis and subtle abnormalities in white matter microstructure. Although EOS patients are more likely to be treatment-refractory than their adult counterparts, there are substantial data that this subgroup is particularly responsive to clozapine. CONCLUSIONS Genetic or environmental factors operating during adolescence that reduce frontal capacity might contribute to an EOS in susceptible individuals. Additional longitudinal studies of adolescents with schizophrenia are needed to better understand the relationship between structural changes in fronto-limbic regions, stress responsivity, and cognitive and neurochemical development.
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Affiliation(s)
- Sanjiv Kumra
- Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota 55454, USA.
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Scorza FA, Cysneiros RM, Terra VC, Scorza CA, Cavalheiro EA, Ribeiro MO, Gattaz WF. Omega-3 consumption and sudden cardiac death in schizophrenia. Prostaglandins Leukot Essent Fatty Acids 2009; 81:241-5. [PMID: 19628381 DOI: 10.1016/j.plefa.2009.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 06/13/2009] [Accepted: 06/29/2009] [Indexed: 10/20/2022]
Abstract
People with schizophrenia show a two- to three-fold increased risk to die prematurely. Mortality is accounted for by a combination of factors (patients' life style, suicide, premature cardiovascular disease, metabolic syndromes and, not so often mentioned, sudden death). The cause of sudden death in schizophrenia is unknown, but cardiac arrhythmia plays a potential role. Patients with schizophrenia are at high risk for cardiovascular disease, and some antipsychotics may be associated with cardiovascular adverse events (e.g., electrocardiograph QT interval prolongation), suggesting that this could lead to sudden cardiac death. Animal and clinical studies have shown that omega-3 fatty acids could be useful in the prevention and treatment of schizophrenia. As omega-3 fatty acids have been considered a cardioprotector agent, reducing cardiac arrhythmias and hence sudden cardiac deaths and given their relative safety and general health benefits, our update article summarizes the knowledge by the possible positive effects of omega-3 supplementation and fish consumption against sudden cardiac death in patients with schizophrenia. However, fish species should be selected with caution due to contamination with toxic methylmercury.
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Affiliation(s)
- Fulvio A Scorza
- Disciplina de Neurologia Experimental, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Rua Botucatu, 862, Edifício Leal Prado, CEP 04023-900, São Paulo, Brazil.
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Qiu A, Zhong J, Graham S, Chia MY, Sim K. Combined analyses of thalamic volume, shape and white matter integrity in first-episode schizophrenia. Neuroimage 2009; 47:1163-71. [DOI: 10.1016/j.neuroimage.2009.04.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 03/26/2009] [Accepted: 04/08/2009] [Indexed: 11/15/2022] Open
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Douaud G, Mackay C, Andersson J, James S, Quested D, Ray MK, Connell J, Roberts N, Crow TJ, Matthews PM, Smith S, James A. Schizophrenia delays and alters maturation of the brain in adolescence. Brain 2009; 132:2437-48. [DOI: 10.1093/brain/awp126] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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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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