1
|
Vieira S, Bolton TAW, Schöttner M, Baecker L, Marquand A, Mechelli A, Hagmann P. Multivariate brain-behaviour associations in psychiatric disorders. Transl Psychiatry 2024; 14:231. [PMID: 38824172 DOI: 10.1038/s41398-024-02954-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024] Open
Abstract
Mapping brain-behaviour associations is paramount to understand and treat psychiatric disorders. Standard approaches involve investigating the association between one brain and one behavioural variable (univariate) or multiple variables against one brain/behaviour feature ('single' multivariate). Recently, large multimodal datasets have propelled a new wave of studies that leverage on 'doubly' multivariate approaches capable of parsing the multifaceted nature of both brain and behaviour simultaneously. Within this movement, canonical correlation analysis (CCA) and partial least squares (PLS) emerge as the most popular techniques. Both seek to capture shared information between brain and behaviour in the form of latent variables. We provide an overview of these methods, review the literature in psychiatric disorders, and discuss the main challenges from a predictive modelling perspective. We identified 39 studies across four diagnostic groups: attention deficit and hyperactive disorder (ADHD, k = 4, N = 569), autism spectrum disorders (ASD, k = 6, N = 1731), major depressive disorder (MDD, k = 5, N = 938), psychosis spectrum disorders (PSD, k = 13, N = 1150) and one transdiagnostic group (TD, k = 11, N = 5731). Most studies (67%) used CCA and focused on the association between either brain morphology, resting-state functional connectivity or fractional anisotropy against symptoms and/or cognition. There were three main findings. First, most diagnoses shared a link between clinical/cognitive symptoms and two brain measures, namely frontal morphology/brain activity and white matter association fibres (tracts between cortical areas in the same hemisphere). Second, typically less investigated behavioural variables in multivariate models such as physical health (e.g., BMI, drug use) and clinical history (e.g., childhood trauma) were identified as important features. Finally, most studies were at risk of bias due to low sample size/feature ratio and/or in-sample testing only. We highlight the importance of carefully mitigating these sources of bias with an exemplar application of CCA.
Collapse
Affiliation(s)
- S Vieira
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
| | - T A W Bolton
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital, Lausanne, Switzerland
| | - M Schöttner
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - L Baecker
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Marquand
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- Department of Neuroimaging, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, UK
| | - A Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - P Hagmann
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
2
|
Zhou Z, Jones K, Ivleva EI, Colon-Perez L. Macro- and Micro-Structural Alterations in the Midbrain in Early Psychosis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.10.588901. [PMID: 38645197 PMCID: PMC11030414 DOI: 10.1101/2024.04.10.588901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Introduction Early psychosis (EP) is a critical period in the course of psychotic disorders during which the brain is thought to undergo rapid and significant functional and structural changes 1 . Growing evidence suggests that the advent of psychotic disorders is early alterations in the brain's functional connectivity and structure, leading to aberrant neural network organization. The Human Connectome Project (HCP) is a global effort to map the human brain's connectivity in healthy and disease populations; within HCP, there is a specific dataset that focuses on the EP subjects (i.e., those within five years of the initial psychotic episode) (HCP-EP), which is the focus of our study. Given the critically important role of the midbrain function and structure in psychotic disorders (cite), and EP in particular (cite), we specifically focused on the midbrain macro- and micro-structural alterations and their association with clinical outcomes in HCP-EP. Methods We examined macro- and micro-structural brain alterations in the HCP-EP sample (n=179: EP, n=123, Controls, n=56) as well as their associations with behavioral measures (i.e., symptoms severity) using a stepwise approach, incorporating a multimodal MRI analysis procedure. First, Deformation Based Morphometry (DBM) was carried out on the whole brain 3 Tesla T1w images to examine gross brain anatomy (i.e., seed-based and voxel-based volumes). Second, we extracted Fractional Anisotropy (FA), Axial Diffusivity (AD), and Mean Diffusivity (MD) indices from the Diffusion Tensor Imaging (DTI) data; a midbrain mask was created based on FreeSurfer v.6.0 atlas. Third, we employed Tract-Based Spatial Statistics (TBSS) to determine microstructural alterations in white matter tracts within the midbrain and broader regions. Finally, we conducted correlation analyses to examine associations between the DBM-, DTI- and TBSS-based outcomes and the Positive and Negative Syndrome Scale (PANSS) scores. Results DBM analysis showed alterations in the hippocampus, midbrain, and caudate/putamen. A DTI voxel-based analysis shows midbrain reductions in FA and AD and increases in MD; meanwhile, the hippocampus shows an increase in FA and a decrease in AD and MD. Several key brain regions also show alterations in DTI indices (e.g., insula, caudate, prefrontal cortex). A seed-based analysis centered around a midbrain region of interest obtained from freesurfer segmentation confirms the voxel-based analysis of DTI indices. TBSS successfully captured structural differences within the midbrain and complementary alterations in other main white matter tracts, such as the corticospinal tract and cingulum, suggesting early altered brain connectivity in EP. Correlations between these quantities in the EP group and behavioral scores (i.e., PANSS and CAINS tests) were explored. It was found that midbrain volume noticeably correlates with the Cognitive score of PA and all DTI metrics. FA correlates with the several dimensions of the PANSS, while AD and MD do not show many associations with PANSS or CAINS. Conclusions Our findings contribute to understanding the midbrain-focused circuitry involvement in EP and complimentary alteration in EP. Our work provides a path for future investigations to inform specific brain-based biomarkers of EP and their relationships to clinical manifestations of the psychosis course.
Collapse
|
3
|
Adams RA, Zor C, Mihalik A, Tsirlis K, Brudfors M, Chapman J, Ashburner J, Paulus MP, Mourão-Miranda J. Voxel-wise multivariate analysis of brain-psychosocial associations in adolescents reveals six latent dimensions of cognition and psychopathology. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00085-5. [PMID: 38588854 DOI: 10.1016/j.bpsc.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/15/2024] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Adolescence heralds the onset of much psychopathology, which may be conceptualized as an emergence of altered covariation between symptoms and brain measures. Multivariate methods can detect such modes of covariation or latent dimensions, but none specifically relating to psychopathology have yet been found using population-level structural brain data. Using voxel-wise (instead of parcellated) brain data may strengthen latent dimensions' brain-psychosocial relationships, but this creates computational challenges. METHODS We obtained voxel-wise grey matter density and psychosocial variables from the baseline (aged 9-10 years) Adolescent Brain and Cognitive Development cohort (n=11288), and employed a state-of-the-art segmentation method, sparse partial least squares, and a rigorous machine learning framework to prevent overfitting. RESULTS We found six latent dimensions, four pertaining specifically to mental health. The mental health dimensions related to overeating, anorexia/internalizing, oppositional symptoms (all p<0.002) and ADHD symptoms (p=0.03). ADHD related to increased and internalizing related to decreased grey matter density in dopaminergic and serotonergic midbrain areas, whereas oppositional symptoms related to increased grey matter in a noradrenergic nucleus. Internalizing related to increased and oppositional symptoms to reduced grey matter density in insula, cingulate and auditory cortices. Striatal regions featured strongly, with reduced caudate nucleus grey matter in ADHD, and reduced putamen grey matter in oppositional/conduct problems. Voxel-wise grey matter density generated stronger brain-psychosocial correlations than brain parcellations. CONCLUSIONS Voxel-wise brain data strengthen latent dimensions of brain-psychosocial covariation and sparse multivariate methods increase their psychopathological specificity. Internalizing and externalizing are associated with opposite grey matter changes in similar cortical and subcortical areas.
Collapse
Affiliation(s)
- Rick A Adams
- Centre for Medical Image Computing, Department of Computer Science, University College London, WC1V 6LJ, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, WC1B 5EH, UK.
| | - Cemre Zor
- Centre for Medical Image Computing, Department of Computer Science, University College London, WC1V 6LJ, UK
| | - Agoston Mihalik
- Centre for Medical Image Computing, Department of Computer Science, University College London, WC1V 6LJ, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, WC1B 5EH, UK; Department of Psychiatry, University of Cambridge, CB2 0SZ, UK
| | - Konstantinos Tsirlis
- Centre for Medical Image Computing, Department of Computer Science, University College London, WC1V 6LJ, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, WC1B 5EH, UK
| | - Mikael Brudfors
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3BG, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, SE1 7EH, UK
| | - James Chapman
- Centre for Medical Image Computing, Department of Computer Science, University College London, WC1V 6LJ, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, WC1B 5EH, UK
| | - John Ashburner
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3BG, UK
| | | | - Janaina Mourão-Miranda
- Centre for Medical Image Computing, Department of Computer Science, University College London, WC1V 6LJ, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, WC1B 5EH, UK
| |
Collapse
|
4
|
MacDowell CJ, Briones BA, Lenzi MJ, Gustison ML, Buschman TJ. Differences in the expression of cortex-wide neural dynamics are related to behavioral phenotype. Curr Biol 2024; 34:1333-1340.e6. [PMID: 38417445 PMCID: PMC10965364 DOI: 10.1016/j.cub.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 01/12/2024] [Accepted: 02/05/2024] [Indexed: 03/01/2024]
Abstract
Behavior differs across individuals, ranging from typical to atypical phenotypes.1 Understanding how differences in behavior relate to differences in neural activity is critical for developing treatments of neuropsychiatric and neurodevelopmental disorders. One hypothesis is that differences in behavior reflect individual differences in the dynamics of how information flows through the brain. In support of this, the correlation of neural activity between brain areas, termed "functional connectivity," varies across individuals2 and is disrupted in autism,3 schizophrenia,4 and depression.5 However, the changes in neural activity that underlie altered behavior and functional connectivity remain unclear. Here, we show that individual differences in the expression of different patterns of cortical neural dynamics explain variability in both functional connectivity and behavior. Using mesoscale imaging, we recorded neural activity across the dorsal cortex of behaviorally "typical" and "atypical" mice. All mice shared the same recurring cortex-wide spatiotemporal motifs of neural activity, and these motifs explained the large majority of variance in cortical activity (>75%). However, individuals differed in how frequently different motifs were expressed. These differences in motif expression explained differences in functional connectivity and behavior across both typical and atypical mice. Our results suggest that differences in behavior and functional connectivity are due to changes in the processes that select which pattern of neural activity is expressed at each moment in time.
Collapse
Affiliation(s)
- Camden J MacDowell
- Princeton Neuroscience Institute, Princeton University, Washington Road, Princeton, NJ 08540 USA; Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901, USA
| | - Brandy A Briones
- Princeton Neuroscience Institute, Princeton University, Washington Road, Princeton, NJ 08540 USA; Department of Psychology, Princeton University, Washington Road, Princeton, NJ 08540, USA; Department of Anesthesiology and Pain Medicine at University of Washington, Seattle, WA 98105, USA
| | - Michael J Lenzi
- Princeton Neuroscience Institute, Princeton University, Washington Road, Princeton, NJ 08540 USA
| | - Morgan L Gustison
- Princeton Neuroscience Institute, Princeton University, Washington Road, Princeton, NJ 08540 USA; Department of Integrative Biology, University of Texas at Austin, Austin, TX 78712, USA; Department of Psychology, Western University, London, ON N6A 3K7, Canada
| | - Timothy J Buschman
- Princeton Neuroscience Institute, Princeton University, Washington Road, Princeton, NJ 08540 USA; Department of Psychology, Princeton University, Washington Road, Princeton, NJ 08540, USA.
| |
Collapse
|
5
|
Preller KH, Scholpp J, Wunder A, Rosenbrock H. Neuroimaging Biomarkers for Drug Discovery and Development in Schizophrenia. Biol Psychiatry 2024:S0006-3223(24)00036-2. [PMID: 38272287 DOI: 10.1016/j.biopsych.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/19/2023] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
Schizophrenia is a chronic mental illness that affects up to 1% of the population. While efficacious therapies are available for positive symptoms, effective treatment of cognitive and negative symptoms remains an unmet need after decades of research. New developments in the field of neuroimaging are accelerating our knowledge gain regarding the underlying pathophysiology of symptoms in schizophrenia and psychosis spectrum disorders, inspiring new targets for drug development. However, no validated and qualified biomarkers are currently available to support the development of new therapeutics. This review summarizes the current use of neuroimaging technology in clinical drug development for psychotic disorders. As exemplified by drug development programs that target NMDA receptor hypofunction, neuroimaging results play a critical role in target discovery and establishing target engagement and dose selection. Furthermore, pharmacological neuroimaging may provide response biomarkers that allow for early decision making in proof-of-concept studies that leverage pharmacological challenge models in healthy volunteers. That said, while response and predictive biomarkers are starting to be evaluated in patient populations, they continue to play a limited role. Novel approaches to neuroimaging data acquisition and analysis may aid the establishment of biomarkers that are predictive at the individual level in the future. Nevertheless, various gaps in knowledge need to be addressed and biomarkers need to be validated to establish them as "fit for purpose" in drug development.
Collapse
Affiliation(s)
- Katrin H Preller
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany; Boehringer Ingelheim (Schweiz) GmbH, Basel, Switzerland.
| | - Joachim Scholpp
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Andreas Wunder
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Holger Rosenbrock
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| |
Collapse
|
6
|
Tumkaya S, Yücens B, Gündüz M, Maheu M, Berkovitch L. Disruption of consciousness depends on insight in OCD and on positive symptoms in schizophrenia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.02.571832. [PMID: 38293050 PMCID: PMC10827121 DOI: 10.1101/2024.01.02.571832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Disruption of conscious access contributes to the advent of psychotic symptoms in schizophrenia but could also explain lack of insight in other psychiatric disorders. In this study, we explored how insight and psychotic symptoms related to disruption of consciousness. We explored consciousness in patients with schizophrenia, patients with obsessive-compulsive disorder (OCD) with good vs. poor insight and matched controls. Participants underwent clinical assessments and performed a visual masking task allowing us to measure individual consciousness threshold. We used a principal component analysis to reduce symptom dimensionality and explored how consciousness measures related to symptomatology. We found that clinical dimensions could be well summarized by a restricted set of principal components which also correlated with the extent of consciousness disruption. More specifically, positive symptoms were associated with impaired conscious access in patients with schizophrenia whereas the level of insight delineated two subtypes of OCD patients, those with poor insight who had consciousness impairments similar to patients with schizophrenia, and those with good insight who resemble healthy controls. Our study provides new insights about consciousness disruption in psychiatric disorders, showing that it relates to positive symptoms in schizophrenia and with insight in OCD. In OCD, it revealed a distinct subgroup sharing neuropathological features with schizophrenia. Our findings refine the mapping between symptoms and cognition, paving the way for a better treatment selection.
Collapse
Affiliation(s)
- Selim Tumkaya
- Department of Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey
- Department of Neuroscience, Pamukkale University School of Medicine, Denizli, Turkey
| | - Bengü Yücens
- Department of Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey
| | - Muhammet Gündüz
- Department of Psychiatry, Government Hospital of Bolvadin, Bolvadin, Turkey
| | - Maxime Maheu
- Department of Neurophysiology and Pathophysiology, Center for Experimental Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Synaptic Physiology, Centre for Molecular Neurobiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Lucie Berkovitch
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- University Department of Psychiatry, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France
- Saclay CEA Centre, Neurospin, Gif-Sur-Yvette Cedex, France
- Paris Cité University, Paris, France
| |
Collapse
|
7
|
Lee K, Ji JL, Fonteneau C, Berkovitch L, Rahmati M, Pan L, Repovš G, Krystal JH, Murray JD, Anticevic A. Human brain state dynamics reflect individual neuro-phenotypes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.18.557763. [PMID: 37790400 PMCID: PMC10542143 DOI: 10.1101/2023.09.18.557763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Neural activity and behavior manifest state and trait dynamics, as well as variation within and between individuals. However, the mapping of state-trait neural variation to behavior is not well understood. To address this gap, we quantify moment-to-moment changes in brain-wide co-activation patterns derived from resting-state functional magnetic resonance imaging. In healthy young adults, we identify reproducible spatio-temporal features of co-activation patterns at the single subject level. We demonstrate that a joint analysis of state-trait neural variations and feature reduction reveal general motifs of individual differences, encompassing state-specific and general neural features that exhibit day-to-day variability. The principal neural variations co-vary with the principal variations of behavioral phenotypes, highlighting cognitive function, emotion regulation, alcohol and substance use. Person-specific probability of occupying a particular co-activation pattern is reproducible and associated with neural and behavioral features. This combined analysis of state-trait variations holds promise for developing reproducible neuroimaging markers of individual life functional outcome.
Collapse
Affiliation(s)
- Kangjoo Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lucie Berkovitch
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Saclay CEA Centre, Neurospin, Gif-Sur-Yvette Cedex, France
- Department of Psychiatry, GHU Paris Psychiatrie et Neurosciences, Service Hospitalo-Universitaire, Paris, France
- Université Paris Cité, 15 Rue de l'École de Médecine, F-75006 Paris, France
| | - Masih Rahmati
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lining Pan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Grega Repovš
- Department of Psychology, University of Ljubljana, Ljubljana, Slovenia
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
- Department of Physics, Yale University, New Haven, CT, USA
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
8
|
Xu B, Dallâ Aglio L, Flournoy J, Bortsova G, Tervo-Clemmens B, Collins P, de Bruijne M, Luciana M, Marquand A, Wang H, Tiemeier H, Muetzel RL. Multivariate brain-based dimensions of child psychiatric problems: degrees of generalizability. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.12.23287158. [PMID: 36993191 PMCID: PMC10055441 DOI: 10.1101/2023.03.12.23287158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Multivariate machine learning techniques are a promising set of tools for identifying complex brain-behavior associations. However, failure to replicate results from these methods across samples has hampered their clinical relevance. This study aimed to delineate dimensions of brain functional connectivity that are associated with child psychiatric symptoms in two large and independent cohorts: the Adolescent Brain Cognitive Development (ABCD) Study and the Generation R Study (total n =8,605). Using sparse canonical correlations analysis, we identified three brain-behavior dimensions in ABCD: attention problems, aggression and rule-breaking behaviors, and withdrawn behaviors. Importantly, out-of-sample generalizability of these dimensions was consistently observed in ABCD, suggesting robust multivariate brain-behavior associations. Despite this, out-of-study generalizability in Generation R was limited. These results highlight that the degree of generalizability can vary depending on the external validation methods employed as well as the datasets used, emphasizing that biomarkers will remain elusive until models generalize better in true external settings.
Collapse
|
9
|
Ji JL, Lencz T, Gallego J, Neufeld N, Voineskos A, Malhotra A, Anticevic A. Informing individualized multi-scale neural signatures of clozapine response in patients with treatment-refractory schizophrenia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.10.23286854. [PMID: 36993630 PMCID: PMC10055439 DOI: 10.1101/2023.03.10.23286854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Clozapine is currently the only antipsychotic with demonstrated efficacy in treatment-refractory schizophrenia (TRS). However, response to clozapine differs widely between TRS patients, and there are no available clinical or neural predictive indicators that could be used to increase or accelerate the use of clozapine in patients who stand to benefit. Furthermore, it remains unclear how the neuropharmacology of clozapine contributes to its therapeutic effects. Identifying the mechanisms underlying clozapine's therapeutic effects across domains of symptomatology could be crucial for development of new optimized therapies for TRS. Here, we present results from a prospective neuroimaging study that quantitatively related heterogeneous patterns of clinical clozapine response to neural functional connectivity at baseline. We show that we can reliably capture specific dimensions of clozapine clinical response by quantifying the full variation across item-level clinical scales, and that these dimensions can be mapped to neural features that are sensitive to clozapine-induced symptom change. Thus, these features may act as "failure modes" that can provide an early indication of treatment (non-)responsiveness. Lastly, we related the response-relevant neural maps to spatial expression profiles of genes coding for receptors implicated in clozapine's pharmacology, demonstrating that distinct dimensions of clozapine symptom-informed neural features may be associated with specific receptor targets. Collectively, this study informs prognostic neuro-behavioral measures for clozapine as a more optimal treatment for selected patients with TRS. We provide support for the identification of neuro-behavioral targets linked to pharmacological efficacy that can be further developed to inform optimal early treatment decisions in schizophrenia.
Collapse
|
10
|
Scholkmann F, Vollenweider FX. Psychedelics and fNIRS neuroimaging: exploring new opportunities. NEUROPHOTONICS 2023; 10:013506. [PMID: 36474478 PMCID: PMC9717437 DOI: 10.1117/1.nph.10.1.013506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
In this Outlook paper, we explain to the optical neuroimaging community as well as the psychedelic research community the great potential of using optical neuroimaging with functional near-infrared spectroscopy (fNIRS) to further explore the changes in brain activity induced by psychedelics. We explain why we believe now is the time to exploit the momentum of the current resurgence of research on the effects of psychedelics and the momentum of the increasing progress and popularity of the fNIRS technique to establish fNIRS in psychedelic research. With this article, we hope to contribute to this development.
Collapse
Affiliation(s)
- Felix Scholkmann
- University Hospital Zurich, University of Zurich, Biomedical Optics Research Laboratory, Department of Neonatology, Zurich, Switzerland
- University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland
| | - Franz X. Vollenweider
- University Hospital of Psychiatry, University of Zurich, Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich, Switzerland
| |
Collapse
|
11
|
Anticevic A, Halassa MM. The thalamus in psychosis spectrum disorder. Front Neurosci 2023; 17:1163600. [PMID: 37123374 PMCID: PMC10133512 DOI: 10.3389/fnins.2023.1163600] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Psychosis spectrum disorder (PSD) affects 1% of the world population and results in a lifetime of chronic disability, causing devastating personal and economic consequences. Developing new treatments for PSD remains a challenge, particularly those that target its core cognitive deficits. A key barrier to progress is the tenuous link between the basic neurobiological understanding of PSD and its clinical phenomenology. In this perspective, we focus on a key opportunity that combines innovations in non-invasive human neuroimaging with basic insights into thalamic regulation of functional cortical connectivity. The thalamus is an evolutionary conserved region that forms forebrain-wide functional loops critical for the transmission of external inputs as well as the construction and update of internal models. We discuss our perspective across four lines of evidence: First, we articulate how PSD symptomatology may arise from a faulty network organization at the macroscopic circuit level with the thalamus playing a central coordinating role. Second, we discuss how recent animal work has mechanistically clarified the properties of thalamic circuits relevant to regulating cortical dynamics and cognitive function more generally. Third, we present human neuroimaging evidence in support of thalamic alterations in PSD, and propose that a similar "thalamocortical dysconnectivity" seen in pharmacological imaging (under ketamine, LSD and THC) in healthy individuals may link this circuit phenotype to the common set of symptoms in idiopathic and drug-induced psychosis. Lastly, we synthesize animal and human work, and lay out a translational path for biomarker and therapeutic development.
Collapse
Affiliation(s)
- Alan Anticevic
- School of Medicine, Yale University, New Haven, CT, United States
- *Correspondence: Alan Anticevic,
| | - Michael M. Halassa
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, United States
- Michael M. Halassa,
| |
Collapse
|
12
|
Moujaes F, Preller KH, Ji JL, Murray JD, Berkovitch L, Vollenweider FX, Anticevic A. Towards mapping neuro-behavioral heterogeneity of psychedelic neurobiology in humans. Biol Psychiatry 2022:S0006-3223(22)01805-4. [PMID: 36715317 DOI: 10.1016/j.biopsych.2022.10.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022]
Abstract
Precision psychiatry aims to identify markers of inter-individual variability that allow predicting the right treatment for each patient. However, bridging the gap between molecular-level manipulations and neural systems-level functional alterations remains an unsolved problem in psychiatry. After decades of low success rates in pharmaceutical R&D for psychiatric drugs, multiple studies now point to the potential of psychedelics as a promising fast-acting and long-lasting treatment for some psychiatric symptoms. Yet, given the highly psychoactive nature of these substances, a precision medicine approach is essential to map the neural signals related to clinical efficacy in order to identify patients who can maximally benefit from this treatment. Recent studies have shown that bridging the gap between pharmacology, systems-level neural response in humans and individual experience is possible for psychedelic substances, therefore paving the way for a precision neuropsychiatric therapeutic development. Specifically, it has been shown that the integration of brain-wide PET or transcriptomic data, i.e. receptor distribution for the serotonin 2A receptor, with computational neuroimaging methods can simulate the effect of psychedelics on the human brain. These novel 'computational psychiatry' approaches allow for modeling inter-individual differences in neural as well as subjective effects of psychedelic substances. Collectively, this review provides a deep dive into psychedelic pharmaco-neuroimaging studies with a core focus on how recent computational psychiatry advances in biophysically based circuit modeling can be leveraged to predict individual responses. Finally, we emphasize the importance of human pharmacological neuroimaging for the continued precision therapeutic development of psychedelics.
Collapse
Affiliation(s)
- Flora Moujaes
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, 8032 Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States
| | - Katrin H Preller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, 8032 Zurich, Switzerland; Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States
| | - John D Murray
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States; Department of Physics, Yale University, New Haven, CT, 06511, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, 06511, United States
| | - Lucie Berkovitch
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States; Université de Paris, 15 Rue de l'École de Médecine, F-75006 Paris, France; Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 1 rue Cabanis, F-75014, Paris, France
| | - Franz X Vollenweider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry Zurich, Lenggstr. 31, 8032 Zurich, Switzerland
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, 06511, United States.
| |
Collapse
|
13
|
Wang Y, Chai L, Chu C, Li D, Gao C, Wu X, Yang Z, Zhang Y, Xu J, Nyengaard JR, Eickhoff SB, Liu B, Madsen KH, Jiang T, Fan L. Uncovering the genetic profiles underlying the intrinsic organization of the human cerebellum. Mol Psychiatry 2022; 27:2619-2634. [PMID: 35264730 DOI: 10.1038/s41380-022-01489-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 11/09/2022]
Abstract
The functional diversity of the human cerebellum is largely believed to be derived more from its extensive connections rather than being limited to its mostly invariant architecture. However, whether and how the determination of cerebellar connections in its intrinsic organization interact with microscale gene expression is still unknown. Here we decode the genetic profiles of the cerebellar functional organization by investigating the genetic substrates simultaneously linking cerebellar functional heterogeneity and its drivers, i.e., the connections. We not only identified 443 network-specific genes but also discovered that their co-expression pattern correlated strongly with intra-cerebellar functional connectivity (FC). Ninety of these genes were also linked to the FC of cortico-cerebellar cognitive-limbic networks. To further discover the biological functions of these genes, we performed a "virtual gene knock-out" by observing the change in the coupling between gene co-expression and FC and divided the genes into two subsets, i.e., a positive gene contribution indicator (GCI+) involved in cerebellar neurodevelopment and a negative gene set (GCI-) related to neurotransmission. A more interesting finding is that GCI- is significantly linked with the cerebellar connectivity-behavior association and many recognized brain diseases that are closely linked with the cerebellar functional abnormalities. Our results could collectively help to rethink the genetic substrates underlying the cerebellar functional organization and offer possible micro-macro interacted mechanistic interpretations of the cerebellum-involved high order functions and dysfunctions in neuropsychiatric disorders.
Collapse
Affiliation(s)
- Yaping Wang
- Sino-Danish Center, University of Chinese Academy of Sciences, 100190, Beijing, China.,University of Chinese Academy of Sciences, 100190, Beijing, China.,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China
| | - Lin Chai
- University of Chinese Academy of Sciences, 100190, Beijing, China.,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China
| | - Congying Chu
- University of Chinese Academy of Sciences, 100190, Beijing, China. .,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China. .,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.
| | - Deying Li
- University of Chinese Academy of Sciences, 100190, Beijing, China.,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China
| | - Chaohong Gao
- Sino-Danish Center, University of Chinese Academy of Sciences, 100190, Beijing, China.,University of Chinese Academy of Sciences, 100190, Beijing, China.,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China
| | - Xia Wu
- University of Chinese Academy of Sciences, 100190, Beijing, China.,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China
| | - Zhengyi Yang
- University of Chinese Academy of Sciences, 100190, Beijing, China.,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China
| | - Yu Zhang
- Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, 311100, China
| | - Junhai Xu
- School of Computer Science and Technology, Tianjin Key Laboratory of Cognitive Computing and Application, Tianjin University, Tianjin, 300350, China
| | - Jens Randel Nyengaard
- Sino-Danish Center, University of Chinese Academy of Sciences, 100190, Beijing, China.,Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, 8000, Aarhus, Denmark.,Department of Pathology, Aarhus University Hospital, 8200, Aarhus, Denmark
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, 52425, Jülich, Germany.,Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Bing Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, 100875, Beijing, China
| | - Kristoffer Hougaard Madsen
- Sino-Danish Center, University of Chinese Academy of Sciences, 100190, Beijing, China.,Department of Informatics and Mathematical Modelling, Technical University of Denmark, 2800, Kongens Lyngby, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, 2650, Hvidovre, Denmark
| | - Tianzi Jiang
- Sino-Danish Center, University of Chinese Academy of Sciences, 100190, Beijing, China.,University of Chinese Academy of Sciences, 100190, Beijing, China.,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China
| | - Lingzhong Fan
- Sino-Danish Center, University of Chinese Academy of Sciences, 100190, Beijing, China. .,University of Chinese Academy of Sciences, 100190, Beijing, China. .,Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China. .,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China. .,CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, 100190, Beijing, China.
| |
Collapse
|
14
|
Avram M, Müller F, Rogg H, Korda A, Andreou C, Holze F, Vizeli P, Ley L, Liechti ME, Borgwardt S. Characterizing thalamocortical (dys)connectivity following d-amphetamine, LSD, and MDMA administration. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:885-894. [PMID: 35500840 DOI: 10.1016/j.bpsc.2022.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/28/2022] [Accepted: 04/13/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with psychotic disorders present alterations in thalamocortical intrinsic functional connectivity (iFC) as measured by resting-state functional magnetic resonance imaging (rs-fMRI). Specifically, thalamic iFC is increased with sensorimotor cortices (hyperconnectivity) and decreased with prefrontal-limbic cortices (hypoconnectivity). Intriguingly, psychedelics such as lysergic acid diethylamide (LSD) elicit similar thalamocortical-hyperconnectivity with sensorimotor areas in healthy volunteers. It is unclear whether LSD also induces thalamocortical-hypoconnectivity with prefrontal-limbic cortices as current findings are equivocal. Notably, thalamocortical-hyperconnectivity was associated with psychotic symptoms in patients and substance-induced altered states of consciousness in healthy volunteers. Thalamocortical dysconnectivity is likely evoked by altered neurotransmission, e.g., via dopaminergic excess in psychotic disorders and serotonergic agonism in psychedelic-induced states. It is unclear whether thalamocortical dysconnectivity is also elicited by amphetamine-type substances, broadly releasing monoamines (i.e., dopamine, norepinephrine) but producing fewer perceptual effects than psychedelics. METHODS We administrated LSD, d-amphetamine, and 3,4-methylenedioxymethamphetamine (MDMA) in 28 healthy volunteers and investigated their effects on thalamic iFC with two brain networks (auditory-sensorimotor (ASM) and salience (SAL) - corresponding to sensorimotor and prefrontal-limbic cortices, respectively), using a double-blind, placebo-controlled, cross-over design. RESULTS All active substances elicited ASM-thalamic-hyperconnectivity compared to placebo, despite predominantly distinct pharmacological actions and subjective effects. LSD-induced effects correlated with subjective changes in perception, indicating a link between hyperconnectivity and psychedelic-type perceptual alterations. Unlike d-amphetamine and MDMA, which induced hypoconnectivity with SAL, LSD elicited hyperconnectivity. D-amphetamine and MDMA evoked similar thalamocortical dysconnectivity patterns. CONCLUSIONS Psychedelics, empathogens, and psychostimulants evoke thalamocortical-hyperconnectivity with sensorimotor areas, akin to findings in patients with psychotic disorders.
Collapse
Affiliation(s)
- Mihai Avram
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, 23538, Germany.
| | - Felix Müller
- Department of Psychiatry (UPK), University of Basel, Basel, 4012, Switzerland
| | - Helena Rogg
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, 23538, Germany
| | - Alexandra Korda
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, 23538, Germany
| | - Christina Andreou
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, 23538, Germany
| | - Friederike Holze
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, 4031, Switzerland
| | - Patrick Vizeli
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, 4031, Switzerland
| | - Laura Ley
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, 4031, Switzerland
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, 4031, Switzerland
| | - Stefan Borgwardt
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, 23538, Germany
| |
Collapse
|
15
|
Zick JL, Staglin B, Vinogradov S. Eliminate schizophrenia. Schizophr Res 2022; 242:147-149. [PMID: 35067455 PMCID: PMC9809202 DOI: 10.1016/j.schres.2022.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/27/2021] [Accepted: 01/02/2022] [Indexed: 01/05/2023]
Abstract
“Schizophrenia” is used as a unitary diagnostic term for an illness that is extremely heterogeneous in its etiology, pathophysiology, presentation, and trajectory. Furthermore, the presence of psychosis—its hallmark characteristic—can be observed in individuals with other diagnoses, and biologically- and computationally-defined psychosis biotypes differ from those associated with DSM diagnoses and yield different treatment predictions. We argue that schizophrenia is not only stigmatizing as a label, it is not useful as a diagnostic term, a disease concept, or a construct for scientific research. Until we are able to delineate a range of dysfunctions across molecular/cellular and/or macrocircuit levels that map onto psychosis-proneness and indicate optimal treatment pathways, we propose to eliminate schizophrenia and replace it with a new nomenclature as an interim solution. Similar to what is done with other broad descriptive disease concepts in medicine which are defined by hallmark clinical features and then further subtyped (e.g., sickle cell anemia, iron deficiency anemia), we propose that psychosis spectrum illnesses (PSIs) be characterized by their temporal characteristics, relevant modifying/causal and symptom features, and treatment responsiveness.
Collapse
Affiliation(s)
- Jennifer L. Zick
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical Center, Minnesota, USA,Corresponding author
| | | | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical Center, Minnesota, USA
| |
Collapse
|