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McHugo M, Roeske MJ, Vandekar SN, Armstrong K, Avery SN, Heckers S. Smaller anterior hippocampal subfields in the early stage of psychosis. Transl Psychiatry 2024; 14:69. [PMID: 38296964 PMCID: PMC10830481 DOI: 10.1038/s41398-023-02719-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 02/02/2024] Open
Abstract
Hippocampal volume is smaller in schizophrenia, but it is unclear when in the illness the changes appear and whether specific regions (anterior, posterior) and subfields (CA1, CA2/3, dentate gyrus, subiculum) are affected. Here, we used a high-resolution T2-weighted sequence specialized for imaging hippocampal subfields to test the hypothesis that anterior CA1 volume is lower in early psychosis. We measured subfield volumes across hippocampal regions in a group of 90 individuals in the early stage of a non-affective psychotic disorder and 70 demographically similar healthy individuals. We observed smaller volume in the anterior CA1 and dentate gyrus subfields in the early psychosis group. Our findings support models that implicate anterior CA1 and dentate gyrus subfield deficits in the mechanism of psychosis.
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Affiliation(s)
- Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Maxwell J Roeske
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon N Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristan Armstrong
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suzanne N Avery
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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O'Neill A, Dooley N, Roddy D, Healy C, Carey E, Frodl T, O'Hanlon E, Cannon M. Longitudinal hippocampal subfield development associated with psychotic experiences in young people. Transl Psychiatry 2024; 14:44. [PMID: 38245522 PMCID: PMC10799917 DOI: 10.1038/s41398-024-02746-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024] Open
Abstract
Hippocampal volumetric reductions are observed across the psychosis spectrum, with interest in the localisation of these reductions within the hippocampal subfields increasing. Deficits of the CA1 subfield in particular have been implicated in the neuropathophysiology of psychotic disorders. Investigating the trajectory of these abnormalities in healthy adolescents reporting sub-threshold psychotic experiences (PE) can provide insight into the neural mechanisms underlying psychotic symptoms without the potentially confounding effects of a formal disorder, or antipsychotic medication. In this novel investigation, a sample of 211 young people aged 11-13 participated initially in the Adolescent Brain Development study. PE classification was determined by expert consensus at each timepoint. Participants underwent neuroimaging at 3 timepoints, over 6 years. 78 participants with at least one scan were included in the final sample; 33 who met criteria for a definite PE at least once across all the timepoints (PE group), and 45 controls. Data from bilateral subfields of interest (CA1, CA2/3, CA4/DG, presubiculum and subiculum) were extracted for Linear Mixed Effects analyses. Before correction, subfield volumes were found to increase in the control group and decrease in the PE group for the right CA2 and CA2/3 subfields, with moderate to large effect sizes (d = -0.61, and d = -0.79, respectively). Before correction, right subiculum and left presubiculum volumes were reduced in the PE group compared to controls, regardless of time, with moderate effect sizes (d = -0.52, and d = -0.59, respectively). However, none of these effects survived correction. Severity of symptoms were not associated with any of the noted subfields. These findings provide novel insight to the discussion of the role of hippocampal subfield abnormalities in the pathophysiology underlying psychotic experiences.
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Affiliation(s)
- Aisling O'Neill
- Department of Psychology, St Patrick's Mental Health Services, Dublin, Ireland.
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, St Stephens Green, Dublin, Ireland.
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - Niamh Dooley
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, St Stephens Green, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Darren Roddy
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, St Stephens Green, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, St Stephens Green, Dublin, Ireland
- Department of Medicine, University College Dublin, Dublin, Ireland
| | - Eleanor Carey
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, St Stephens Green, Dublin, Ireland
| | - Thomas Frodl
- Department of Medicine, University College Dublin, Dublin, Ireland
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Uniklinik RWTH Aachen, Aachen, Germany
| | - Erik O'Hanlon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, St Stephens Green, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, St Stephens Green, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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Aberizk K, Sefik E, Addington J, Anticevic A, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Keshavan M, Mathalon DH, Perkins DO, Stone WS, Tsuang MT, Woods SW, Walker EF. Hippocampal Connectivity with the Default Mode Network is Linked to Hippocampal Volume in the Clinical High Risk for Psychosis Syndrome and Healthy Individuals. Clin Psychol Sci 2023; 11:801-818. [PMID: 37981950 PMCID: PMC10656030 DOI: 10.1177/21677026221138819] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Reduced hippocampal volume (HV) is an established brain morphological feature of psychiatric conditions. HV is associated with brain connectivity in humans and non-human animals and altered connectivity is associated with risk for psychiatric illness. Associations between HV and connectivity remain poorly characterized in humans, and especially in phases of psychiatric illness that precede disease onset. This study examined associations between HV and hippocampal functional connectivity (FC) during rest in 141 healthy controls and 248 individuals at-risk for psychosis. Significant inverse associations between HV and hippocampal FC with the inferior parietal lobe (IPL) and thalamus were observed. Select associations between hippocampal FC and HV were moderated by diagnostic group. Significant moderation results shifted from implicating the IPL to the temporal pole after excluding participants on antipsychotic medication. Considered together, this work implicates hippocampal FC with the temporoparietal junction, within a specialized subsystem of the default mode network, as sensitive to HV.
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Affiliation(s)
- Katrina Aberizk
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Esra Sefik
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Carrie E. Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, USA
| | | | | | | | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School, Harvard University, Cambridge, MA, USA
| | - Daniel H. Mathalon
- Department of Psychiatry, University of California, San Francisco, CA, USA
- San Francisco VA Medical Center, San Francisco, CA, USA
| | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - William S. Stone
- Department of Psychiatry, Harvard Medical School, Harvard University, Cambridge, MA, USA
| | - Ming T. Tsuang
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
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Andreou C, Eickhoff S, Heide M, de Bock R, Obleser J, Borgwardt S. Predictors of transition in patients with clinical high risk for psychosis: an umbrella review. Transl Psychiatry 2023; 13:286. [PMID: 37640731 PMCID: PMC10462748 DOI: 10.1038/s41398-023-02586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/03/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
Diagnosis of a clinical high-risk (CHR) state enables timely treatment of individuals at risk for a psychotic disorder, thereby contributing to improving illness outcomes. However, only a minority of patients diagnosed with CHR will make the transition to overt psychosis. To identify patients most likely to benefit from early intervention, several studies have investigated characteristics that distinguish CHR patients who will later develop a psychotic disorder from those who will not. We aimed to summarize evidence from systematic reviews and meta-analyses on predictors of transition to psychosis in CHR patients, among characteristics and biomarkers assessed at baseline. A systematic search was conducted in Pubmed, Scopus, PsychInfo and Cochrane databases to identify reviews and meta-analyses of studies that investigated specific baseline predictors or biomarkers for transition to psychosis in CHR patients using a cross-sectional or longitudinal design. Non-peer-reviewed publications, gray literature, narrative reviews and publications not written in English were excluded from analyses. We provide a narrative synthesis of results from all included reviews and meta-analyses. For each included publication, we indicate the number of studies cited in each domain and its quality rating. A total of 40 publications (21 systematic reviews and 19 meta-analyses) that reviewed a total of 272 original studies qualified for inclusion. Baseline predictors most consistently associated with later transition included clinical characteristics such as attenuated psychotic and negative symptoms and functioning, verbal memory deficits and the electrophysiological marker of mismatch negativity. Few predictors reached a level of evidence sufficient to inform clinical practice, reflecting generalizability issues in a field characterized by studies with small, heterogeneous samples and relatively few transition events. Sample pooling and harmonization of methods across sites and projects are necessary to overcome these limitations.
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Affiliation(s)
- Christina Andreou
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
- Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Sofia Eickhoff
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Marco Heide
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Renate de Bock
- University Psychiatric Clinics Basel, Wilhelm Klein-Strasse 27, 4002, Basel, Switzerland
| | - Jonas Obleser
- Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
- Department of Psychology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
- Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
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Alexandros Lalousis P, Wood S, Reniers R, Schmaal L, Azam H, Mazziota A, Saeed H, Wragg C, Upthegrove R. Transdiagnostic structural neuroimaging features in depression and psychosis: A systematic review. Neuroimage Clin 2023; 38:103388. [PMID: 37031636 PMCID: PMC10120394 DOI: 10.1016/j.nicl.2023.103388] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Previous research suggests that there may be similarities in structural brain changes seen in patients with depression and psychosis compared to healthy controls. However, there is yet no systematic review collating studies comparing structural brain changes in depression and psychosis. Establishing shared and specific neuroanatomical features could aid the investigation of underlying biological processes. AIMS To identify structural neuroimaging similarities and differences between patients with depression and psychosis. METHOD We searched PubMed, PsychInfo, Embase, NICE Evidence, Medline and the Cochrane Library were searched from inception to 30/06/2021 using relevant subject headings (controlled vocabularies) and search syntax. Papers were assessed for quality using the Newcastle-Ottawa Scale. RESULTS Five-hundred and twenty papers were retrieved, seven met inclusion criteria. In narrative collation of results, grey matter volume (GMV) reductions were found in the medial frontal gyrus (MFG), hippocampus and left-sided posterior subgenual prefrontal cortex in both psychosis and depression. GMV reductions affected more brain regions in psychosis, including in the insula and thalamus. White matter volume (WMV) decline was found in both depression and psychosis. Reduced fractional anisotropy (FA) was more commonly seen in depression. CONCLUSIONS Our results suggest potential transdiagnostic patterns of GMV and WMV reductions in areas including the MFG, hippocampus, and left-sided posterior subgenual prefrontal cortex. These could be investigated as a future biomarker of transdiagnostic signature across mental illnesses. However, due to the limited number and poor quality of studies future research in large samples and harmonised imaging data is first needed.
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Affiliation(s)
- Paris Alexandros Lalousis
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham B15 2SA, United Kingdom.
| | - Stephen Wood
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham B15 2SA, United Kingdom; Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Renate Reniers
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham B15 2SA, United Kingdom
| | - Lianne Schmaal
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Hannah Azam
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom
| | - Antonella Mazziota
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom
| | - Hasson Saeed
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom
| | - Charlotte Wragg
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham B15 2SA, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham B15 2SA, United Kingdom
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Oliver D, Davies C, Zelaya F, Selvaggi P, De Micheli A, Catalan A, Baldwin H, Arribas M, Modinos G, Crossley NA, Allen P, Egerton A, Jauhar S, Howes OD, McGuire P, Fusar-Poli P. Parsing neurobiological heterogeneity of the clinical high-risk state for psychosis: A pseudo-continuous arterial spin labelling study. Front Psychiatry 2023; 14:1092213. [PMID: 36970257 PMCID: PMC10031088 DOI: 10.3389/fpsyt.2023.1092213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/15/2023] [Indexed: 03/10/2023] Open
Abstract
Introduction The impact of the clinical high-risk for psychosis (CHR-P) construct is dependent on accurately predicting outcomes. Individuals with brief limited intermittent psychotic symptoms (BLIPS) have higher risk of developing a first episode of psychosis (FEP) compared to individuals with attenuated psychotic symptoms (APS). Supplementing subgroup stratification with information from candidate biomarkers based on neurobiological parameters, such as resting-state, regional cerebral blood flow (rCBF), may help refine risk estimates. Based on previous evidence, we hypothesized that individuals with BLIPS would exhibit increased rCBF compared to APS in key regions linked to dopaminergic pathways. Methods Data from four studies were combined using ComBat (to account for between-study differences) to analyse rCBF in 150 age- and sex-matched subjects (n = 30 healthy controls [HCs], n = 80 APS, n = 20 BLIPS and n = 20 FEP). Global gray matter (GM) rCBF was examined in addition to region-of-interest (ROI) analyses in bilateral/left/right frontal cortex, hippocampus and striatum. Group differences were assessed using general linear models: (i) alone; (ii) with global GM rCBF as a covariate; (iii) with global GM rCBF and smoking status as covariates. Significance was set at p < 0.05. Results Whole-brain voxel-wise analyses and Bayesian ROI analyses were also conducted. No significant group differences were found in global [F(3,143) = 1,41, p = 0.24], bilateral frontal cortex [F(3,143) = 1.01, p = 0.39], hippocampus [F(3,143) = 0.63, p = 0.60] or striatum [F(3,143) = 0.52, p = 0.57] rCBF. Similar null findings were observed in lateralized ROIs (p > 0.05). All results were robust to addition of covariates (p > 0.05). No significant clusters were identified in whole-brain voxel-wise analyses (p > 0.05FWE). Weak-to-moderate evidence was found for an absence of rCBF differences between APS and BLIPS in Bayesian ROI analyses. Conclusion On this evidence, APS and BLIPS are unlikely to be neurobiologically distinct. Due to this and the weak-to-moderate evidence for the null hypothesis, future research should investigate larger samples of APS and BLIPS through collaboration across large-scale international consortia.
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Affiliation(s)
- Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Fernando Zelaya
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Pierluigi Selvaggi
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | - Andrea De Micheli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Mental Health Department, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, Biocruces Bizkaia Health Research Institute, UPV/EHU, University of the Basque Country, Barakaldo, Spain
| | - Helen Baldwin
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Maite Arribas
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Nicolas A. Crossley
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, University of Roehampton, London, United Kingdom
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sameer Jauhar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Oliver D. Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, National Institute for Health Research, London, United Kingdom
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, National Institute for Health Research, London, United Kingdom
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Abstract
Despite strong evidence of the neurodevelopmental origins of psychosis, current pharmacological treatment is not usually initiated until after a clinical diagnosis is made, and is focussed on antagonising striatal dopamine receptors. These drugs are only partially effective, have serious side effects, fail to alleviate the negative and cognitive symptoms of the disorder, and are not useful as a preventive treatment. In recent years, attention has turned to upstream brain regions that regulate striatal dopamine function, such as the hippocampus. This review draws together these recent data to discuss why the hippocampus may be especially vulnerable in the pathophysiology of psychosis. First, we describe the neurodevelopmental trajectory of the hippocampus and its susceptibility to dysfunction, exploring this region's proneness to structural and functional imbalances, metabolic pressures, and oxidative stress. We then examine mechanisms of hippocampal dysfunction in psychosis and in individuals at high-risk for psychosis and discuss how and when hippocampal abnormalities may be targeted in these groups. We conclude with future directions for prospective studies to unlock the discovery of novel therapeutic strategies targeting hippocampal circuit imbalances to prevent or delay the onset of psychosis.
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Structural and Functional Deviations of the Hippocampus in Schizophrenia and Schizophrenia Animal Models. Int J Mol Sci 2022; 23:ijms23105482. [PMID: 35628292 PMCID: PMC9143100 DOI: 10.3390/ijms23105482] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 01/04/2023] Open
Abstract
Schizophrenia is a grave neuropsychiatric disease which frequently onsets between the end of adolescence and the beginning of adulthood. It is characterized by a variety of neuropsychiatric abnormalities which are categorized into positive, negative and cognitive symptoms. Most therapeutical strategies address the positive symptoms by antagonizing D2-dopamine-receptors (DR). However, negative and cognitive symptoms persist and highly impair the life quality of patients due to their disabling effects. Interestingly, hippocampal deviations are a hallmark of schizophrenia and can be observed in early as well as advanced phases of the disease progression. These alterations are commonly accompanied by a rise in neuronal activity. Therefore, hippocampal formation plays an important role in the manifestation of schizophrenia. Furthermore, studies with animal models revealed a link between environmental risk factors and morphological as well as electrophysiological abnormalities in the hippocampus. Here, we review recent findings on structural and functional hippocampal abnormalities in schizophrenic patients and in schizophrenia animal models, and we give an overview on current experimental approaches that especially target the hippocampus. A better understanding of hippocampal aberrations in schizophrenia might clarify their impact on the manifestation and on the outcome of this severe disease.
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O'Neill A, Dooley N, Healy C, Carey E, Roddy D, Frodl T, O’Hanlon E, Cannon M. Longitudinal grey matter development associated with psychotic experiences in young people. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 3:264-273. [PMID: 37124352 PMCID: PMC10140460 DOI: 10.1016/j.bpsgos.2022.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/21/2022] [Accepted: 02/03/2022] [Indexed: 10/19/2022] Open
Abstract
Background Gray matter abnormalities are observed across the psychosis spectrum. The trajectory of these abnormalities in healthy adolescents reporting subthreshold psychotic experiences (PEs) may provide insight into the neural mechanisms underlying psychotic symptoms. The risk of psychosis and additional psychopathology is even higher among these individuals who also report childhood adversity/DSM-5 diagnoses. Thus, the aims of this longitudinal study were to investigate PE-related volumetric changes in young people, noting any effects of childhood adversity/DSM-5 diagnosis. Methods A total of 211 young people 11 to 13 years of age participated in the initial Adolescent Brain Development study. PE classification was determined by expert consensus at each time point. Participants underwent neuroimaging at 3 time points over 6 years. A total of 76 participants with at least one scan were included in the final sample; 34 who met criteria for PEs at least once across all the time points (PE group) and 42 control subjects. Data from 20 bilateral regions of interest were extracted for linear mixed-effects analyses. Results Right hippocampal volume increased over time in the control group, with no increase in the PE group (p = .00352). DSM-5 diagnosis and childhood adversity were not significantly associated with right hippocampal volume. There was no significant effect of group or interaction in any other region. Conclusions These findings further implicate right hippocampal volumetric abnormalities in the pathophysiology underlying PEs. Furthermore, as suggested by previous studies in those at clinical high risk for psychosis and those with first-episode psychosis, it is possible that these deficits may be a marker for later clinical outcomes.
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Brunner G, Gajwani R, Gross J, Gumley AI, Krishnadas R, Lawrie SM, Schwannauer M, Schultze-Lutter F, Fracasso A, Uhlhaas PJ. Hippocampal structural alterations in early-stage psychosis: Specificity and relationship to clinical outcomes. NEUROIMAGE: CLINICAL 2022; 35:103087. [PMID: 35780662 PMCID: PMC9421451 DOI: 10.1016/j.nicl.2022.103087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
Individuals with early-stage psychosis show reduced hippocampal volumes. FEP show bilateral and widespread changes, while left hemisphere is affected in CHR-P. However, hippocampal changes do not show a relationship with clinical outcomes.
Hippocampal dysfunctions are a core feature of schizophrenia, but conflicting evidence exists whether volumetric and morphological changes are present in early-stage psychosis and to what extent these deficits are related to clinical trajectories. In this study, we recruited individuals at clinical high risk for psychosis (CHR-P) (n = 108), patients with a first episode of psychosis (FEP) (n = 37), healthy controls (HC) (n = 70) as well as a psychiatric control group with substance abuse and affective disorders (CHR-N: n = 38). MRI-data at baseline were obtained and volumetric as well as vertex analyses of the hippocampus were carried out. Moreover, volumetric changes were examined in the amygdala, caudate, nucleus accumbens, pallidum, putamen and thalamus. In addition, we obtained follow-up functional and symptomatic assessments in CHR-P individuals to examine the question whether anatomical deficits at baseline predicted clinical trajectories. Our results show that the hippocampus is the only structure showing significant volumetric decrease in early-stage psychosis, with FEPs showing significantly smaller hippocampal volumes bilaterally alongside widespread shape changes in the vertex analysis. For the CHR-P group, volumetric decreases were confined to the left hippocampus. However, hippocampal alterations in the CHR-P group were not robustly associated with clinical outcomes, including the persistence of attenuated psychotic symptoms and functional trajectories. Accordingly, our findings highlight that dysfunctions in hippocampal anatomy are an important feature of early-stage psychosis which may, however, not be related to clinical outcomes in CHR-P participants.
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Affiliation(s)
- Gina Brunner
- Institute for Neuroscience and Psychology, Univ. of Glasgow, UK
| | | | - Joachim Gross
- Institute for Neuroscience and Psychology, Univ. of Glasgow, UK; Institute of Biomagnetism and Biosignalanalysis, University of Muenster, Muenster, Germany
| | | | | | | | | | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | | | - Peter J Uhlhaas
- Institute for Neuroscience and Psychology, Univ. of Glasgow, UK; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
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