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Yamazaki R, Matsumoto J, Ito S, Nemoto K, Fukunaga M, Hashimoto N, Kodaka F, Takano H, Hasegawa N, Yasuda Y, Fujimoto M, Yamamori H, Watanabe Y, Miura K, Hashimoto R. Longitudinal reduction in brain volume in patients with schizophrenia and its association with cognitive function. Neuropsychopharmacol Rep 2024; 44:206-215. [PMID: 38348613 PMCID: PMC10932790 DOI: 10.1002/npr2.12423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Establishing a brain biomarker for schizophrenia is strongly desirable not only to support diagnosis by psychiatrists but also to help track the progressive changes in the brain over the course of the illness. A brain morphological signature of schizophrenia was reported in a recent study and is defined by clusters of brain regions with reduced volume in schizophrenia patients compared to healthy individuals. This signature was proven to be effective at differentiating patients with schizophrenia from healthy individuals, suggesting that it is a good candidate brain biomarker of schizophrenia. However, the longitudinal characteristics of this signature have remained unclear. In this study, we examined whether these changes occurred over time and whether they were associated with clinical outcomes. We found a significant change in the brain morphological signature in schizophrenia patients with more brain volume loss than the natural, age-related reduction in healthy individuals, suggesting that this change can capture a progressive morphological change in the brain. We further found a significant association between changes in the brain morphological signature and changes in the full-scale intelligence quotient (IQ). The patients with IQ improvement showed preserved brain morphological signatures, whereas the patients without IQ improvement showed progressive changes in the brain morphological signature, suggesting a link between potential recovery of intellectual abilities and the speed of brain pathology progression. We conclude that the brain morphological signature is a brain biomarker that can be used to evaluate progressive changes in the brain that are associated with cognitive impairment due to schizophrenia.
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Affiliation(s)
- Ryuichi Yamazaki
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
- Department of PsychiatryThe Jikei University School of MedicineTokyoJapan
| | - Junya Matsumoto
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
| | - Satsuki Ito
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
- Department of Developmental and Clinical Psychology, The Division of Human Developmental Sciences, Graduate School of Humanity and SciencesOchanomizu UniversityTokyoJapan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Institute of MedicineUniversity of TsukubaTsukubaJapan
| | - Masaki Fukunaga
- Section of Brain Function InformationNational Institute for Physiological SciencesOkazakiJapan
| | - Naoki Hashimoto
- Department of PsychiatryHokkaido University Graduate School of MedicineSapporoJapan
| | - Fumitoshi Kodaka
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
- Department of PsychiatryThe Jikei University School of MedicineTokyoJapan
| | - Harumasa Takano
- Department of Clinical Neuroimaging, Integrative Brain Imaging CenterNational Center of Neurology and PsychiatryKodairaJapan
| | - Naomi Hasegawa
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
| | - Yuka Yasuda
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
- Life Grow Brilliant Mental Clinic, Medical Corporation FosterOsakaJapan
| | - Michiko Fujimoto
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
- Department of PsychiatryOsaka University Graduate School of MedicineSuitaJapan
| | - Hidenaga Yamamori
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
- Department of PsychiatryOsaka University Graduate School of MedicineSuitaJapan
- Japan Community Health Care Organization Osaka HospitalOsakaJapan
| | | | - Kenichiro Miura
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
| | - Ryota Hashimoto
- Department of Pathology of Mental DiseasesNational Institute of Mental Health, National Center of Neurology and PsychiatryKodairaJapan
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Ziemka-Nalecz M, Pawelec P, Ziabska K, Zalewska T. Sex Differences in Brain Disorders. Int J Mol Sci 2023; 24:14571. [PMID: 37834018 PMCID: PMC10572175 DOI: 10.3390/ijms241914571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
A remarkable feature of the brain is its sexual dimorphism. Sexual dimorphism in brain structure and function is associated with clinical implications documented previously in healthy individuals but also in those who suffer from various brain disorders. Sex-based differences concerning some features such as the risk, prevalence, age of onset, and symptomatology have been confirmed in a range of neurological and neuropsychiatric diseases. The mechanisms responsible for the establishment of sex-based differences between men and women are not fully understood. The present paper provides up-to-date data on sex-related dissimilarities observed in brain disorders and highlights the most relevant features that differ between males and females. The topic is very important as the recognition of disparities between the sexes might allow for the identification of therapeutic targets and pharmacological approaches for intractable neurological and neuropsychiatric disorders.
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Affiliation(s)
| | | | | | - Teresa Zalewska
- NeuroRepair Department, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5, A. Pawinskiego Str., 02-106 Warsaw, Poland; (M.Z.-N.); (P.P.); (K.Z.)
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Abbas MS, Nassar ST, Tasha T, Desai A, Bajgain A, Ali A, Dutta C, Pasha K, Paul S, Venugopal S. Exercise as an Adjuvant Treatment of Schizophrenia: A Review. Cureus 2023; 15:e42084. [PMID: 37602139 PMCID: PMC10434720 DOI: 10.7759/cureus.42084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Schizophrenia is a chronic debilitating condition associated with impaired social functioning, memory, and executive functioning. To date, we are still unsure about the exact etiology of schizophrenia, but there are many factors, such as genetics, diminished hippocampal volume, and imbalance of neurotransmitters, that lead to the pathogenies of the disease. Antipsychotics are the most effective treatment option for schizophrenia so far, yet they are associated with a wide array of side effects, ranging from extrapyramidal side effects to conditions, such as metabolic syndrome. Exercise has been shown to increase neural connections in the brain, which can improve cognition and memory. This literature review focuses on the signs and symptoms of schizophrenia, its treatment options, and how exercise can help with some of the symptoms of schizophrenia, especially the negative symptoms that are least effectively treated by antipsychotics.
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Affiliation(s)
- Muhammad S Abbas
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sondos T Nassar
- Medicine and Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tasniem Tasha
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Anjali Desai
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Anjana Bajgain
- Division of Research & Academic Affairs, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Asna Ali
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Chandrani Dutta
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Khadija Pasha
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Salomi Paul
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sathish Venugopal
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Cui Y, Li C, Liu B, Sui J, Song M, Chen J, Chen Y, Guo H, Li P, Lu L, Lv L, Ning Y, Wan P, Wang H, Wang H, Wu H, Yan H, Yan J, Yang Y, Zhang H, Zhang D, Jiang T. Consistent brain structural abnormalities and multisite individualised classification of schizophrenia using deep neural networks. Br J Psychiatry 2022; 221:732-739. [PMID: 35144702 DOI: 10.1192/bjp.2022.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Previous analyses of grey and white matter volumes have reported that schizophrenia is associated with structural changes. Deep learning is a data-driven approach that can capture highly compact hierarchical non-linear relationships among high-dimensional features, and therefore can facilitate the development of clinical tools for making a more accurate and earlier diagnosis of schizophrenia. AIMS To identify consistent grey matter abnormalities in patients with schizophrenia, 662 people with schizophrenia and 613 healthy controls were recruited from eight centres across China, and the data from these independent sites were used to validate deep-learning classifiers. METHOD We used a prospective image-based meta-analysis of whole-brain voxel-based morphometry. We also automatically differentiated patients with schizophrenia from healthy controls using combined grey matter, white matter and cerebrospinal fluid volumetric features, incorporated a deep neural network approach on an individual basis, and tested the generalisability of the classification models using independent validation sites. RESULTS We found that statistically reliable schizophrenia-related grey matter abnormalities primarily occurred in regions that included the superior temporal gyrus extending to the temporal pole, insular cortex, orbital and middle frontal cortices, middle cingulum and thalamus. Evaluated using leave-one-site-out cross-validation, the performance of the classification of schizophrenia achieved by our findings from eight independent research sites were: accuracy, 77.19-85.74%; sensitivity, 75.31-89.29% and area under the receiver operating characteristic curve, 0.797-0.909. CONCLUSIONS These results suggest that, by using deep-learning techniques, multidimensional neuroanatomical changes in schizophrenia are capable of robustly discriminating patients with schizophrenia from healthy controls, findings which could facilitate clinical diagnosis and treatment in schizophrenia.
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Affiliation(s)
- Yue Cui
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China
| | - Chao Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China
| | - Bing Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, China and Chinese Institute for Brain Research, China
| | - Jing Sui
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, China
| | - Ming Song
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, China
| | - Yunchun Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, China
| | - Peng Li
- Peking University Sixth Hospital/Institute of Mental Health, China and Key Laboratory of Mental Health, Ministry of Health (Peking University), China
| | - Lin Lu
- Peking University Sixth Hospital/Institute of Mental Health, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), China and Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China and Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, China
| | - Yuping Ning
- Guangzhou Brain Hospital, Guangzhou Hui-Ai Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, China
| | - Ping Wan
- Zhumadian Psychiatric Hospital, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, China
| | - Huawang Wu
- Guangzhou Brain Hospital, Guangzhou Hui-Ai Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, China
| | - Hao Yan
- Peking University Sixth Hospital/Institute of Mental Health, China and Key Laboratory of Mental Health, Ministry of Health (Peking University), China
| | - Jun Yan
- Peking University Sixth Hospital/Institute of Mental Health, China and Key Laboratory of Mental Health, Ministry of Health (Peking University), China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China, Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, China and CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China, Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, China and Department of Psychology, Xinxiang Medical University, China
| | - Dai Zhang
- Peking University Sixth Hospital/Institute of Mental Health, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), China and Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, China
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, China; Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, China and Queensland Brain Institute, University of Queensland, Australia
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5
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Wannan CMJ, Bartholomeusz CF, Pantelis C, Di Biase MA, Syeda WT, Chakravarty MM, Bousman CA, Everall IP, McGorry PD, Zalesky A, Cropley VL. Disruptions in white matter microstructure associated with impaired visual associative memory in schizophrenia-spectrum illness. Eur Arch Psychiatry Clin Neurosci 2022; 272:971-83. [PMID: 34557990 DOI: 10.1007/s00406-021-01333-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022]
Abstract
Episodic memory ability relies on hippocampal-prefrontal connectivity. However, few studies have examined relationships between memory performance and white matter (WM) microstructure in hippocampal-prefrontal pathways in schizophrenia-spectrum disorder (SSDs). Here, we investigated these relationships in individuals with first-episode psychosis (FEP) and chronic schizophrenia-spectrum disorders (SSDs) using tractography analysis designed to interrogate the microstructure of WM tracts in the hippocampal-prefrontal pathway. Measures of WM microstructure (fractional anisotropy [FA], radial diffusivity [RD], and axial diffusivity [AD]) were obtained for 47 individuals with chronic SSDs, 28 FEP individuals, 52 older healthy controls, and 27 younger healthy controls. Tractography analysis was performed between the hippocampus and three targets involved in hippocampal-prefrontal connectivity (thalamus, amygdala, nucleus accumbens). Measures of WM microstructure were then examined in relation to episodic memory performance separately across each group. Both those with FEP and chronic SSDs demonstrated impaired episodic memory performance. However, abnormal WM microstructure was only observed in individuals with chronic SSDs. Abnormal WM microstructure in the hippocampal-thalamic pathway in the right hemisphere was associated with poorer memory performance in individuals with chronic SSDs. These findings suggest that disruptions in WM microstructure in the hippocampal-prefrontal pathway may contribute to memory impairments in individuals with chronic SSDs but not FEP.
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6
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Shailaja B, Javadekar A, Chaudhury S, Saldanha D. Clinical correlates of regional gray matter volumes in schizophrenia: A structural magnetic resonance imaging study. Ind Psychiatry J 2022; 31:282-292. [PMID: 36419700 PMCID: PMC9678149 DOI: 10.4103/ipj.ipj_104_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/21/2021] [Accepted: 10/12/2021] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVES The objective of this study is to investigate the correlation between the regional gray matter volumes and length of Para Cingulate Sulcus (PCS) with the clinical profile of patients with schizophrenia. MATERIALS AND METHODS In this hospital-based, cross-sectional study, thirty consecutive in-patients diagnosed with schizophrenia and equal number of healthy volunteers matched for age- and sex- were recruited as controls. Detailed clinical assessment and magnetic resonance imaging (MRI) of the brain were carried out within 2 days for controls and within 2 weeks of hospitalization for patients. The Positive and Negative Syndrome Scale and Montreal Cognitive Assessment were applied to schizophrenia patients to assess symptoms and cognitive function, respectively. RESULTS Schizophrenia patients had significant volume deficit in bilateral amygdalae, bilateral superior temporal gyri, anterior cingulate cortex and bilateral hippocampi, along with a highly significant reduction in the length of right PCS. Schizophrenia patients with the duration of untreated psychosis (DUP) of 6-12 months showed a significantly greater volume of the right superior temporal gyrus (STG). First-episode schizophrenia patients had a significant reduction in the length of the left PCS. The volume of bilateral superior temporal gyri in schizophrenia patients showed a significant direct correlation with positive symptoms and an inverse correlation with negative symptoms. CONCLUSION Schizophrenia patients have significant volume deficit in some brain regions. DUP of 6-12 months is associated with significantly greater volume of the right STG. First-episode schizophrenia patients have a significant reduction in the length of the left PCS. In schizophrenia patients, the volume of bilateral superior temporal gyri showed a significant direct correlation with the positive symptoms and an inverse correlation with the negative symptoms.
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Affiliation(s)
- B Shailaja
- Department of Psychiatry, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Archana Javadekar
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Daniel Saldanha
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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7
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Patel ZM, Holbrook EH, Turner JH, Adappa ND, Albers MW, Altundag A, Appenzeller S, Costanzo RM, Croy I, Davis GE, Dehgani-Mobaraki P, Doty RL, Duffy VB, Goldstein BJ, Gudis DA, Haehner A, Higgins TS, Hopkins C, Huart C, Hummel T, Jitaroon K, Kern RC, Khanwalkar AR, Kobayashi M, Kondo K, Lane AP, Lechner M, Leopold DA, Levy JM, Marmura MJ, Mclelland L, Miwa T, Moberg PJ, Mueller CA, Nigwekar SU, O'Brien EK, Paunescu TG, Pellegrino R, Philpott C, Pinto JM, Reiter ER, Roalf DR, Rowan NR, Schlosser RJ, Schwob J, Seiden AM, Smith TL, Soler ZM, Sowerby L, Tan BK, Thamboo A, Wrobel B, Yan CH. International consensus statement on allergy and rhinology: Olfaction. Int Forum Allergy Rhinol 2022; 12:327-680. [PMID: 35373533 DOI: 10.1002/alr.22929] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/01/2021] [Accepted: 11/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature regarding clinical olfaction, olfactory loss, and olfactory dysfunction has expanded rapidly over the past two decades, with an exponential rise in the past year. There is substantial variability in the quality of this literature and a need to consolidate and critically review the evidence. It is with that aim that we have gathered experts from around the world to produce this International Consensus on Allergy and Rhinology: Olfaction (ICAR:O). METHODS Using previously described methodology, specific topics were developed relating to olfaction. Each topic was assigned a literature review, evidence-based review, or evidence-based review with recommendations format as dictated by available evidence and scope within the ICAR:O document. Following iterative reviews of each topic, the ICAR:O document was integrated and reviewed by all authors for final consensus. RESULTS The ICAR:O document reviews nearly 100 separate topics within the realm of olfaction, including diagnosis, epidemiology, disease burden, diagnosis, testing, etiology, treatment, and associated pathologies. CONCLUSION This critical review of the existing clinical olfaction literature provides much needed insight and clarity into the evaluation, diagnosis, and treatment of patients with olfactory dysfunction, while also clearly delineating gaps in our knowledge and evidence base that we should investigate further.
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Affiliation(s)
- Zara M Patel
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Eric H Holbrook
- Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Justin H Turner
- Otolaryngology, Vanderbilt School of Medicine, Nashville, Tennessee, USA
| | - Nithin D Adappa
- Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mark W Albers
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Aytug Altundag
- Otolaryngology, Biruni University School of Medicine, İstanbul, Turkey
| | - Simone Appenzeller
- Rheumatology, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Richard M Costanzo
- Physiology and Biophysics and Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Ilona Croy
- Psychology and Psychosomatic Medicine, TU Dresden, Dresden, Germany
| | - Greg E Davis
- Otolaryngology, Proliance Surgeons, Seattle and Puyallup, Washington, USA
| | - Puya Dehgani-Mobaraki
- Associazione Naso Sano, Umbria Regional Registry of Volunteer Activities, Corciano, Italy
| | - Richard L Doty
- Smell and Taste Center, Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | | | - David A Gudis
- Otolaryngology, Columbia University Irving Medical Center, New York, USA
| | - Antje Haehner
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | - Thomas S Higgins
- Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Claire Hopkins
- Otolaryngology, Guy's and St. Thomas' Hospitals, London Bridge Hospital, London, UK
| | - Caroline Huart
- Otorhinolaryngology, Cliniques universitaires Saint-Luc, Institute of Neuroscience, Université catholgique de Louvain, Brussels, Belgium
| | - Thomas Hummel
- Smell and Taste, Otolaryngology, TU Dresden, Dresden, Germany
| | | | - Robert C Kern
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ashoke R Khanwalkar
- Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - Masayoshi Kobayashi
- Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Kenji Kondo
- Otolaryngology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Andrew P Lane
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matt Lechner
- Otolaryngology, Barts Health and University College London, London, UK
| | - Donald A Leopold
- Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Joshua M Levy
- Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael J Marmura
- Neurology Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lisha Mclelland
- Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Takaki Miwa
- Otolaryngology, Kanazawa Medical University, Ishikawa, Japan
| | - Paul J Moberg
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Sagar U Nigwekar
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin K O'Brien
- Otolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Teodor G Paunescu
- Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Carl Philpott
- Otolaryngology, University of East Anglia, Norwich, UK
| | - Jayant M Pinto
- Otolaryngology, University of Chicago, Chicago, Illinois, USA
| | - Evan R Reiter
- Otolaryngology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - David R Roalf
- Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas R Rowan
- Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Schlosser
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - James Schwob
- Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Allen M Seiden
- Otolaryngology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - Timothy L Smith
- Otolaryngology, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Zachary M Soler
- Otolaryngology, Medical University of South Carolina, Mt Pleasant, South Carolina, USA
| | - Leigh Sowerby
- Otolaryngology, University of Western Ontario, London, Ontario, Canada
| | - Bruce K Tan
- Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andrew Thamboo
- Otolaryngology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bozena Wrobel
- Otolaryngology, Keck School of Medicine, USC, Los Angeles, California, USA
| | - Carol H Yan
- Otolaryngology, School of Medicine, UCSD, La Jolla, California, USA
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8
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Büki A, Bohár Z, Kekesi G, Vécsei L, Horvath G. Wisket rat model of schizophrenia: Impaired motivation and, altered brain structure, but no anhedonia. Physiol Behav 2021; 244:113651. [PMID: 34800492 DOI: 10.1016/j.physbeh.2021.113651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 01/17/2023]
Abstract
It is well-known that the poor cognition in schizophrenia is strongly linked to negative symptoms, including motivational deficit, which due to, at least partially, anhedonia. The goal of this study was to explore whether the schizophrenia-like Wisket animals with impaired motivation (obtained in the reward-based hole-board test), also show decreased hedonic behavior (investigated with the sucrose preference test). While neurochemical alterations of different neurotransmitter systems have been detected in the Wisket rats, no research has been performed on structural changes. Therefore, our additional aim was to reveal potential neuroanatomical and structural alterations in different brain regions in these rats. The rats showed decreased general motor activity (locomotion, rearing and exploration) and impaired task performance in the hole-board test compared to the controls, whereas no significant difference was observed in the sucrose preference test between the groups. The Wisket rats exhibited a significant decrease in the frontal cortical thickness and the hippocampal area, and moderate increases in the lateral ventricles and cell disarray in the CA3 subfield of hippocampus. To our knowledge, this is the first study to investigate the hedonic behavior and neuroanatomical alterations in a multi-hit animal model of schizophrenia. The results obtained in the sucrose preference test suggest that anhedonic behavior might not be involved in the impaired motivation obtained in the hole-board test. The neuropathological changes agree with findings obtained in patients with schizophrenia, which refine the high face validity of the Wisket model.
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Affiliation(s)
- Alexandra Büki
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., Szeged, H-6720, Hungary.
| | - Zsuzsanna Bohár
- MTA-SZTE Neuroscience Research Group, Semmelweis u. 6, Szeged, H-6725, Hungary
| | - Gabriella Kekesi
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., Szeged, H-6720, Hungary
| | - László Vécsei
- MTA-SZTE Neuroscience Research Group, Semmelweis u. 6, Szeged, H-6725, Hungary; Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6., Szeged, H-6725, Hungary; Interdisciplinary Excellence Center, Department of Neurology, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis u. 6., Szeged, H-6725 Hungary
| | - Gyongyi Horvath
- Department of Physiology, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 10., Szeged, H-6720, Hungary
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9
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Karantonis JA, Carruthers SP, Rossell SL, Pantelis C, Hughes M, Wannan C, Cropley V, Van Rheenen TE. A Systematic Review of Cognition-Brain Morphology Relationships on the Schizophrenia-Bipolar Disorder Spectrum. Schizophr Bull 2021; 47:1557-1600. [PMID: 34097043 PMCID: PMC8530395 DOI: 10.1093/schbul/sbab054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The nature of the relationship between cognition and brain morphology in schizophrenia-spectrum disorders (SSD) and bipolar disorder (BD) is uncertain. This review aimed to address this, by providing a comprehensive systematic investigation of links between several cognitive domains and brain volume, cortical thickness, and cortical surface area in SSD and BD patients across early and established illness stages. An initial search of PubMed and Scopus databases resulted in 1486 articles, of which 124 met inclusion criteria and were reviewed in detail. The majority of studies focused on SSD, while those of BD were scarce. Replicated evidence for specific regions associated with indices of cognition was minimal, however for several cognitive domains, the frontal and temporal regions were broadly implicated across both recent-onset and established SSD, and to a lesser extent BD. Collectively, the findings of this review emphasize the significance of both frontal and temporal regions for some domains of cognition in SSD, while highlighting the need for future BD-related studies on this topic.
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Affiliation(s)
- James A Karantonis
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Sean P Carruthers
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Susan L Rossell
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- St Vincent’s Mental Health, St Vincent’s Hospital, Melbourne, Australia
| | - Christos Pantelis
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Australia
- Department of Electrical and Electronic Engineering, University of Melbourne, Melbourne, Australia
| | - Matthew Hughes
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Cassandra Wannan
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Vanessa Cropley
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
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10
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Rapado-Castro M, Villar-Arenzana M, Janssen J, Fraguas D, Bombin I, Castro-Fornieles J, Mayoral M, González-Pinto A, de la Serna E, Parellada M, Moreno D, Paya B, Graell M, Baeza I, Pantelis C, Arango C. 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; 10:3929. [PMID: 34501377 DOI: 10.3390/jcm10173929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [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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11
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Bandeira ID, Barouh JL, Bandeira ID, Quarantini L. Analysis of the superior temporal gyrus as a possible biomarker in schizophrenia using voxel-based morphometry of the brain magnetic resonance imaging: a comprehensive review. CNS Spectr 2021; 26:319-25. [PMID: 31918770 DOI: 10.1017/S1092852919001810] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The lack of predictive biomarkers for therapeutic responses to schizophrenia leads clinical procedures to be decided without taking into account the subjects' neuroanatomical features, a consideration, which could help in identifying specific pharmacological treatments for the remission of symptoms. Magnetic resonance imaging (MRI) is a technique widely used for radiological diagnosis and produces 3-dimensional images in excellent anatomical detail, and with a great capacity to differentiate soft tissue. Various MRI techniques of the human brain have emerged as a result of research, enabling structural tests that may help to in consolidate previous findings and lead to the discovery of new patterns of abnormality in schizophrenia. A literature review was undertaken to assess the superior temporal gyrus (STG) as a possible biomarker in schizophrenia with the use of voxel-based morphometry of the brain using MRI. Many findings in studies of schizophrenia using MRI have been inconclusive and, in some cases, conflicting, although interesting results have been obtained when attempting to correlate neuroimaging changes with aspects of clinical features and prognosis of the disease. The individuals affected by this mental illness appear to have smaller STG volumes when compared to healthy controls and also to subjects with a diagnosis of first-episode affective psychosis or groups of individuals at high risk of psychosis. However, the wide variety of definitions surrounding the STG found in a number of studies is a contributing factor to the lack of correlation between brain abnormalities and clinical symptoms. For instance, disagreements have arisen due to studies using regions of interest to analyze the STG whereas other studies prioritize the analysis of only STG subregions or specific supratemporal plane regions. It is necessary to standardize the nomenclature of the areas to be studied in the future, as this will enable more consistent results, allowing higher clinical and morphological correlations.
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12
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Iliuta FP, Manea MC, Budisteanu M, Ciobanu AM, Manea M. Magnetic resonance imaging in schizophrenia: Luxury or necessity? (Review). Exp Ther Med 2021; 22:765. [PMID: 34055064 PMCID: PMC8145262 DOI: 10.3892/etm.2021.10197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/16/2021] [Indexed: 11/12/2022] Open
Abstract
Schizophrenia, one of the most common psychiatric disorders, with a worldwide annual incidence rate of approximately 0.3-0.7%, known to affect the population below 25 years of age, is persistent throughout lifetime and includes people from all layers of society. With recent technological progress that allows better imaging techniques, such as the ones provided by computed tomography and particularly magnetic resonance imaging (MRI), research on schizophrenia imaging has grown considerably. The purpose of this review is to establish the importance of using imaging techniques in the early detection of brain abnormalities in patients diagnosed with schizophrenia. We reviewed all articles which reported on MRI imaging in schizophrenia. In order to do this, we used the PubMed database, using as search words ‘MRI’ and ‘schizophrenia’. MRI studies of first episode patients and chronic patients, suggest reduction of the whole brain volume. Enlargement of lateral ventricles was described as positive in 15 studies out of 19 and was similar to findings in chronic patients. Moreover, for the first episode patients, all data collected point to important changes in medial temporal lobe structures, diminished hippocampal volume, the whole frontal lobe, asymmetry in prefrontal cortex, diminished volume in cingulate, corpus callosum, and cavum septum pellucidum reported abnormalities. MRI is recommended as an important tool in the follow-up process of patients with schizophrenia. Yet, it is still under debate whether the abnormalities described in this condition are able to be used as diagnostic biomarkers.
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Affiliation(s)
- Floris Petru Iliuta
- Psychiatry Research Laboratory, 'Prof. Dr. Alexandru Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.,Department of Psychiatry and Psychology, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 010221 Bucharest, Romania
| | - Mihnea Costin Manea
- Psychiatry Research Laboratory, 'Prof. Dr. Alexandru Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.,Department of Psychiatry and Psychology, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 010221 Bucharest, Romania
| | - Magdalena Budisteanu
- Psychiatry Research Laboratory, 'Prof. Dr. Alexandru Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.,Laboratory of Medical Genetics, 'Victor Babes' National Institute of Pathology, 050096 Bucharest, Romania.,Medical Genetics Department, Faculty of Medicine, 'Titu Maiorescu' University, 031593 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Department of Neuroscience, Discipline of Psychiatry, Faculty of General Medicine, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Psychiatry, 'Prof. Dr. Alexandru Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Mirela Manea
- Psychiatry Research Laboratory, 'Prof. Dr. Alexandru Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.,Department of Psychiatry and Psychology, Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy, 010221 Bucharest, Romania
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13
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Edemann-Callesen H, Winter C, Hadar R. Using cortical non-invasive neuromodulation as a potential preventive treatment in schizophrenia - A review. Brain Stimul 2021; 14:643-651. [PMID: 33819680 DOI: 10.1016/j.brs.2021.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 02/11/2021] [Accepted: 03/23/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Evidence suggests that schizophrenia constitutes a neurodevelopmental disorder, characterized by a gradual emergence of behavioral and neurobiological abnormalities over time. Therefore, applying early interventions to prevent later manifestation of symptoms is appealing. OBJECTIVE This review focuses on the use of cortical neuromodulation in schizophrenia and its potential as a preventive treatment approach. We present clinical and preclinical findings investigating the use of neuromodulation in schizophrenia, including the current research focusing on cortical non-invasive stimulation and its possibility as a future preventive treatment. METHODS We performed a search in Medline (PubMed) in September 2020 using a combination of relevant medical subject headings (MeSH) and text words. The search included human and preclinical trials as well as existing systematic reviews and meta-analysis. There were no restrictions on language or the date of publication. RESULTS Neurodevelopmental animal models may be used to investigate how the disease progresses and thus which brain areas ideally should be targeted at a given time point. Here, abnormalities of the prefrontal cortex have been often identified as an early and persistent impairment in schizophrenia. Currently there is insufficient evidence to either support or refute the use of neuromodulation to the cortex in adult patients with already manifested symptoms. However, preclinical results show that early non-invasive neuromodulation to the prefrontal cortex of adolescent animals, sufficiently prevents later psychosis-relevant abnormalities in adulthood. This points to the promising potential of cortical non-invasive neuromodulation as a preventive treatment when applied early in the course of the disease. CONCLUSION Preclinical translational-oriented findings indicate, that neuromodulation to cortical areas offers the possibility of targeting early neuropathology and through this diminish the progression of a later schizophrenic profile. Further studies are needed to investigate whether such early cortical stimulation may serve as a future preventive treatment in schizophrenia.
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Affiliation(s)
- Henriette Edemann-Callesen
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité -Universitätsmedizin, Berlin, Germany
| | - Christine Winter
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité -Universitätsmedizin, Berlin, Germany
| | - Ravit Hadar
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité -Universitätsmedizin, Berlin, Germany.
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14
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Stoyanov D, Aryutova K, Kandilarova S, Paunova R, Arabadzhiev Z, Todeva-Radneva A, Kostianev S, Borgwardt S. Diagnostic Task Specific Activations in Functional MRI and Aberrant Connectivity of Insula with Middle Frontal Gyrus Can Inform the Differential Diagnosis of Psychosis. Diagnostics (Basel) 2021; 11:95. [PMID: 33435624 PMCID: PMC7827259 DOI: 10.3390/diagnostics11010095] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/19/2022] Open
Abstract
We constructed a novel design integrating the administration of a clinical self-assessment scale with simultaneous acquisition of functional Magnetic Resonance Imaging (fMRI), aiming at cross-validation between psychopathology evaluation and neuroimaging techniques. We hypothesized that areas demonstrating differential activation in two groups of patients (the first group exhibiting paranoid delusions in the context of paranoid schizophrenia-SCH-and second group with a depressive episode in the context of major depressive disorder or bipolar disorder-DEP) will have distinct connectivity patterns and structural differences. Fifty-one patients with SCH (n = 25) or DEP (n = 26) were scanned with three different MRI sequences: a structural and two functional sequences-resting-state and task-related fMRI (the stimuli represent items from a paranoid-depressive self-evaluation scale). While no significant differences were found in gray matter volumes, we were able to discriminate between the two clinical entities by identifying two significant clusters of activations in the SCH group-the left Precuneus (PreCu) extending to the left Posterior Cingulate Cortex (PCC) and the right Angular Gyrus (AG). Additionally, the effective connectivity of the middle frontal gyrus (MFG), a part of the Dorsolateral Prefrontal Cortex (DLPFC) to the Anterior Insula (AI), demonstrated a significant difference between the two groups with inhibitory connection demonstrated only in SCH. The observed activations of PreCu, PCC, and AG (involved in the Default Mode Network DMN) might be indirect evidence of the inhibitory connection from the DLPFC to AI, interfering with the balancing function of the insula as the dynamic switch in the DMN. The findings of our current study might suggest that the connectivity from DLPFC to the anterior insula can be interpreted as evidence for the presence of an aberrant network that leads to behavioral abnormalities, the manifestation of which depends on the direction of influence. The reduced effective connectivity from the AI to the DLPFC is manifested as depressive symptoms, and the inhibitory effect from the DLPFC to the AI is reflected in the paranoid symptoms of schizophrenia.
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Affiliation(s)
- Drozdstoy Stoyanov
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria; (K.A.); (S.K.); (R.P.); (Z.A.); (A.T.-R.)
| | - Katrin Aryutova
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria; (K.A.); (S.K.); (R.P.); (Z.A.); (A.T.-R.)
| | - Sevdalina Kandilarova
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria; (K.A.); (S.K.); (R.P.); (Z.A.); (A.T.-R.)
| | - Rositsa Paunova
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria; (K.A.); (S.K.); (R.P.); (Z.A.); (A.T.-R.)
| | - Zlatoslav Arabadzhiev
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria; (K.A.); (S.K.); (R.P.); (Z.A.); (A.T.-R.)
| | - Anna Todeva-Radneva
- Department of Psychiatry and Medical Psychology, and Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria; (K.A.); (S.K.); (R.P.); (Z.A.); (A.T.-R.)
| | - Stefan Kostianev
- Department of Pathophysiology, and Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Stefan Borgwardt
- Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, 23538 Lübeck, Germany;
- Department of Psychiatry, University of Basel, 4001 Basel, Switzerland
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15
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Peng Y, Zhang S, Zhou Y, Song Y, Yang G, Hao K, Yang Y, Li W, Lv L, Zhang Y. Abnormal functional connectivity based on nodes of the default mode network in first-episode drug-naive early-onset schizophrenia. Psychiatry Res 2021; 295:113578. [PMID: 33243520 DOI: 10.1016/j.psychres.2020.113578] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/13/2020] [Indexed: 02/06/2023]
Abstract
Schizophrenia is considered a connectivity disorder. Further, the functional connectivity (FC) of the default-mode network (DMN) has gained the interest of researchers. However, few studies have been conducted on the abnormal connectivity of DMN in early-onset schizophrenia (EOS). In this study, the key brain regions of the DMN were used as seed regions to analyze the FC of the whole brain in EOS. When the seed was located in the medial prefrontal cortex (mPFC), patients with EOS exhibited decreased FC between mPFC and other brain regions compared with healthy controls (voxel P value < 0.001, cluster P value < 0.05, Gaussian random field corrected). When the seed was located in the posterior cingulate cortex (PCC), the FC between PCC and other brain regions was enhanced and weakened (voxel P value < 0.001, cluster P value < 0.05, Gaussian random field corrected), and PCC connectivity with the right parahippocampal gyrus was associated with Positive and Negative Syndrome Scale scores for the general score (r = -0.315, P = 0.02). The results showed that the FC within the DMN and that between DMN and visual networks were abnormal, suggesting that the DMN might be involved in the pathogenesis of EOS.
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Affiliation(s)
- Yue Peng
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.
| | - Sen Zhang
- Mental Health Center of Shantou University, Shantou, Guangdong, China.
| | - Youqi Zhou
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China.
| | - Yichen Song
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.
| | - Ge Yang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.
| | - Keke Hao
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.
| | - Yongfeng Yang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.
| | - Wenqiang Li
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China.
| | - Luxian Lv
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.
| | - Yan Zhang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.
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16
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Sydnor VJ, Roalf DR. A meta-analysis of ultra-high field glutamate, glutamine, GABA and glutathione 1HMRS in psychosis: Implications for studies of psychosis risk. Schizophr Res 2020; 226:61-69. [PMID: 32723493 PMCID: PMC7750272 DOI: 10.1016/j.schres.2020.06.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022]
Abstract
Ultra-high field proton magnetic resonance spectroscopy (1HMRS) offers a unique opportunity to measure the concentration of neurometabolites implicated in psychosis (PSY). The extant 7 T 1HMRS literature measuring glutamate-associated neurometabolites in the brain in PSY in vivo is small, but a comprehensive, quantitative summary of these data can offer insight and guidance to this emerging field. This meta-analysis examines proton spectroscopy (1HMRS) measures of glutamate (Glu), glutamine (Gln), glutamate+glutamine (Glx), gamma aminobutyric acid (GABA), and glutathione (GSH) across 255 individuals with PSY (121 first episode) and 293 healthy comparison participants (HC). While all five neurometabolites were lower in PSY as compared to HC, only Glu (Cohen's d = -0.18) and GSH (Cohen's d = -0.21) concentrations were significantly lower in PSY, whereas concentrations of Gln, Glx, and GABA did not significantly differ between groups. Notably, 1HMRS methodological choices and sample demographic characteristics did not impact study-specific effect sizes for PSY-related Glu or GSH differences. This review thus provides further evidence of neurometabolite dysfunction in first episode and chronic PSY, and thereby suggests that Glu and GSH abnormalities may additionally play a role in more incipient stages of the disorder: in clinical high risk stages. Additional 7 T neurochemical imaging studies in larger, longitudinal, and unmedicated samples and in youth at risk for developing psychosis are needed. Such studies will be critical for elucidating the neurodevelopmental and clinical time course of PSY-related neurometabolite alterations, and for assessing the potential for implicated metabolites to serve as druggable targets for decreasing PSY risk.
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Affiliation(s)
- Valerie J Sydnor
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - David R Roalf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States of America; Lifespan Brain Institute at the Children's Hospital of Philadelphia & the University of Pennsylvania, Philadelphia, PA 19104, United States of America.
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17
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Affiliation(s)
- Lena Palaniyappan
- From the Robarts Research Institute, Western University (Palaniyappan); the Department of Psychiatry, Western University (Palaniyappan, Sukumar); the Lawson Health Research Institute, Imaging Division (Palaniyappan); and the Department of Medical Biophysics, Western University (Palaniyappan), London, Ont., Canada
| | - Niron Sukumar
- From the Robarts Research Institute, Western University (Palaniyappan); the Department of Psychiatry, Western University (Palaniyappan, Sukumar); the Lawson Health Research Institute, Imaging Division (Palaniyappan); and the Department of Medical Biophysics, Western University (Palaniyappan), London, Ont., Canada
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18
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Roalf DR, de la Garza AG, Rosen A, Calkins ME, Moore TM, Quarmley M, Ruparel K, Xia CH, Rupert PE, Satterthwaite TD, Shinohara RT, Elliott MA, Gur RC, Gur RE. Alterations in white matter microstructure in individuals at persistent risk for psychosis. Mol Psychiatry 2020; 25:2441-2454. [PMID: 30723287 PMCID: PMC6682472 DOI: 10.1038/s41380-019-0360-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/02/2019] [Accepted: 01/11/2019] [Indexed: 12/18/2022]
Abstract
Abnormalities in brain white matter (WM) are reported in youth at-risk for psychosis. Yet, the neurodevelopmental time course of these abnormalities remains unclear. Thus, longitudinal diffusion-weighted imaging (DWI) was used to investigate WM abnormalities in youth at-risk for psychosis. A subset of individuals from the Philadelphia Neurodevelopmental Cohort (PNC) completed two DWI scans approximately 20 months apart. Youths were identified through structured interview as having subthreshold persistent psychosis risk symptoms (n = 46), and were compared to healthy typically developing participants (TD; n = 98). Analyses were conducted at voxelwise and regional levels. Nonlinear developmental patterns were examined using penalized splines within a generalized additive model. Compared to TD, youth with persistent psychosis risk symptoms had lower whole-brain WM fractional anisotropy (FA) and higher radial diffusivity (RD). Voxelwise analyses revealed clusters of significant WM abnormalities within the temporal and parietal lobes. Lower FA within the cingulum bundle of hippocampus and cerebrospinal tracts were the most robust deficits in individuals with persistent psychosis symptoms. These findings were consistent over two visits. Thus, it appears that WM abnormalities are present early in youth with persistent psychosis risk symptoms, however, there is little evidence to suggest that these features emerge in late adolescence or early adulthood. Future studies should seek to characterize WM abnormalities in younger individuals and follow individuals as subthreshold psychotic symptoms emerge.
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Affiliation(s)
- David R. Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Angel Garcia de la Garza
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Adon Rosen
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tyler M. Moore
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Megan Quarmley
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cedric Huchuan Xia
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Petra E. Rupert
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Theodore D. Satterthwaite
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T. Shinohara
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Mark A. Elliott
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.,Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Raquel E. Gur
- Brain Behavior Laboratory, Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.,Lifespan Brain Institute (LiBI) at the University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, PA, 19104, USA.,Department of Child and Adolescent Psychiatry, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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19
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van Haren N, Cahn W, Hulshoff Pol H, Kahn R. Schizophrenia as a progressive brain disease. Eur Psychiatry 2020; 23:245-54. [DOI: 10.1016/j.eurpsy.2007.10.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 10/11/2007] [Accepted: 10/18/2007] [Indexed: 01/06/2023] Open
Abstract
AbstractThere is convincing evidence that schizophrenia is characterized by abnormalities in brain volume. At the Department of Psychiatry of the University Medical Centre Utrecht, Netherlands, we have been carrying out neuroimaging studies in schizophrenia since 1995. We focused our research on three main questions. First, are brain volume abnormalities static or progressive in nature? Secondly, can brain volume abnormalities in schizophrenia be explained (in part) by genetic influences? Finally, what environmental factors are associated with the brain volume abnormalities in schizophrenia?Based on our findings we suggest that schizophrenia is a progressive brain disease. We showed different age-related trajectories of brain tissue loss suggesting that brain maturation that occurs in the third and fourth decade of life is abnormal in schizophrenia. Moreover, brain volume has been shown to be a useful phenotype for studying schizophrenia. Brain volume is highly heritable and twin and family studies show that unaffected relatives show abnormalities that are similar, but usually present to a lesser extent, to those found in the patients. However, also environmental factors play a role. Medication intake is indeed a confounding factor when interpreting brain volume (change) abnormalities, while independent of antipsychotic medication intake brain volume abnormalities appear influenced by the outcome of the illness.In conclusion, schizophrenia can be considered as a progressive brain disease with brain volume abnormalities that are for a large part influenced by genetic factors. Whether the progressive volume change is also mediated by genes awaits the results of longitudinal twin analyses. One of the main challenges for the coming years, however, will be the search for gene-by-environment interactions on the progressive brain changes in schizophrenia.
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20
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Hummer TA, Yung MG, Goñi J, Conroy SK, Francis MM, Mehdiyoun NF, Breier A. Functional network connectivity in early-stage schizophrenia. Schizophr Res 2020; 218:107-115. [PMID: 32037204 DOI: 10.1016/j.schres.2020.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/29/2022]
Abstract
Schizophrenia is a disorder of altered neural connections resulting in impaired information integration. Whole brain assessment of within- and between-network connections may determine how information processing is disrupted in schizophrenia. Patients with early-stage schizophrenia (n = 56) and a matched control sample (n = 32) underwent resting-state fMRI scans. Gray matter regions were organized into nine distinct functional networks. Functional connectivity was calculated between 278 gray matter regions for each subject. Network connectivity properties were defined by the mean and variance of correlations of all regions. Whole-brain network measures of global efficiency (reflecting overall interconnectedness) and locations of hubs (key regions for communication) were also determined. The control sample had greater connectivity between the following network pairs: somatomotor-limbic, somatomotor-default mode, dorsal attention-default mode, ventral attention-limbic, and ventral attention-default mode. The patient sample had greater variance in interactions between ventral attention network and other functional networks. Illness duration was associated with overall increases in the variability of network connections. The control group had higher global efficiency and more hubs in the cerebellum network, while patient group hubs were more common in visual, frontoparietal, or subcortical networks. Thus, reduced functional connectivity in patients was largely present between distinct networks, rather than within-networks. The implications of these findings for the pathophysiology of schizophrenia are discussed.
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Affiliation(s)
- Tom A Hummer
- Department of Psychiatry, Indiana University School of Medicine, United States of America; Indiana University Psychotic Disorders Program, Indiana University School of Medicine, United States of America.
| | - Matthew G Yung
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Joaquín Goñi
- Center for Neuroimaging, Indiana University School of Medicine, United States of America; Weldon School of Biomedical Engineering, Purdue University, United States of America
| | - Susan K Conroy
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Michael M Francis
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Nicole F Mehdiyoun
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Alan Breier
- Department of Psychiatry, Indiana University School of Medicine, United States of America
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21
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Sauras R, Keymer A, Alonso-solis A, Díaz A, Molins C, Nuñez F, Rabella M, Roldán A, Grasa E, Alvarez E, Portella M, Corripio I. Volumetric and morphological characteristics of the hippocampus are associated with progression to schizophrenia in patients with first-episode psychosis. Eur Psychiatry 2017; 45:1-5. [DOI: 10.1016/j.eurpsy.2017.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 01/06/2023] Open
Abstract
AbstractBackground:Abnormalities in the hippocampus have been implicated in the pathophysiology of psychosis. However, it is still unclear whether certain abnormalities are a pre-existing vulnerability factor, a sign of disease progression or a consequence of environmental factors. We hypothesized that first-episode psychosis patients who progress to schizophrenia after one year of follow up will display greater volumetric and morphological changes from the very beginning of the disorder.Methods:We studied the hippocampus of 41 patients with a first-episode psychosis and 41 matched healthy controls. MRI was performed at the time of the inclusion in the study. After one year, the whole sample was reevaluated and divided in two groups depending on the diagnoses (schizophrenia vs. non-schizophrenia).Results:Patients who progressed to schizophrenia showed a significantly smaller left hippocampus volume than control group and no-schizophrenia group (F = 3.54; df = 2, 77; P = 0.03). We also found significant differences in the morphology of the anterior hippocampus (CA1) of patients with first-episode psychosis who developed schizophrenia compared with patients who did not.Conclusions:These results are consistent with the assumption of hyperfunctioning dopaminergic cortico-subcortical circuits in schizophrenia, which might be related with an alteration of subcortical structures, such as the hippocampus, along the course of the disease. According with these results, hippocampus abnormalities may serve as a prognostic marker of clinical outcome in patients with a first-episode psychosis.
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22
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Abstract
Despite convergent evidence suggesting that schizophrenia is a disorder of brain dysconnectivity, it remains unclear whether intra- or inter-hemispheric deficits or their combination underlie the dysconnection. This study examined the source of the functional dysconnection in schizophrenia. Resting-state fMRI was performed in 66 patients with schizophrenia and 73 matched healthy controls. Functional brain networks were constructed for each participant and further partitioned into intra- and inter-hemispheric connections. We examined how schizophrenia altered the intra-hemispheric topological properties and the inter-hemispheric nodal strength. Although several subcortical and cingulate regions exhibited hemispheric-independent aberrations of regional efficiency, the optimal small-world properties in the hemispheric networks and their lateralization were preserved in patients. A significant deficit in the inter-hemispheric connectivity was revealed in most of the hub regions, leading to an inter-hemispheric hypo-connectivity pattern in patients. These abnormal intra- and inter-hemispheric network organizations were associated with the clinical features of schizophrenia. The patients in the present study received different medications. These findings provide new insights into the nature of dysconnectivity in schizophrenia, highlighting the dissociable processes between the preserved intra-hemispheric network topology and altered inter-hemispheric functional connectivity.
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Affiliation(s)
- Yuan Zhang
- Key Laboratory for Biomedical Engineering of the Ministry of Education, Department of Biomedical Engineering, Zhejiang University, Zhejiang, 310000, China.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Zhongxiang Dai
- Department of Computer Science, National University of Singapore, Singapore, Singapore
| | - Yu Chen
- School of Computer Engineering, Nanyang Technological University, Singapore, Singapore
| | - Kang Sim
- Department of General Psychiatry, Institute of Mental Health, Singapore, Singapore.,Department of Research, Institute of Mental Health, Singapore, Singapore
| | - Yu Sun
- Key Laboratory for Biomedical Engineering of the Ministry of Education, Department of Biomedical Engineering, Zhejiang University, Zhejiang, 310000, China.
| | - Rongjun Yu
- Department of Psychology, National University of Singapore, Block AS4, #02-07, 9 Arts Link, Singapore, 117570, Singapore. .,Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore.
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23
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Li J, Sun Y, Huang Y, Bezerianos A, Yu R. Machine learning technique reveals intrinsic characteristics of schizophrenia: an alternative method. Brain Imaging Behav 2019; 13:1386-96. [PMID: 30159765 DOI: 10.1007/s11682-018-9947-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Machine learning technique has long been utilized to assist disease diagnosis, increasing clinical physicians' confidence in their decision and expediting the process of diagnosis. In this case, machine learning technique serves as a tool for distinguishing patients from healthy people. Additionally, it can also serve as an exploratory method to reveal intrinsic characteristics of a disease based on discriminative features, which was demonstrated in this study. Resting-state functional magnetic resonance imaging (fMRI) data were obtained from 148 participants (including patients with schizophrenia and healthy controls). Connective strengths were estimated by Pearson correlation for each pair of brain regions partitioned according to automated anatomical labelling atlas. Subsequently, consensus connections with high discriminative power were extracted under the circumstance of the best classification accuracy. Investigating these consensus connections, we found that schizophrenia group predominately exhibited weaker strengths of inter-regional connectivity compared to healthy group. Aberrant connectivities in both intra- and inter-hemispherical connections were observed. Within intra-hemispherical connections, the number of aberrant connections in the right hemisphere was more than that of the left hemisphere. In the exploration of large regions, we revealed that the serious dysconnectivities mainly appeared on temporal and occipital regions for the within-large-region connections; while connectivity disruption was observed on the connections from temporal region to occipital, insula and limbic regions for the between-large-region connections. The findings of this study corroborate previous conclusion of dysconnectivity in schizophrenia and further shed light on distribution patterns of dysconnectivity, which deepens the understanding of pathological mechanism of schizophrenia.
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24
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Sukumar N, Sabesan P, Anazodo U, Palaniyappan L. Neurovascular Uncoupling in Schizophrenia: A Bimodal Meta-Analysis of Brain Perfusion and Glucose Metabolism. Front Psychiatry 2020; 11:754. [PMID: 32848931 PMCID: PMC7427579 DOI: 10.3389/fpsyt.2020.00754] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 07/16/2020] [Indexed: 01/06/2023] Open
Abstract
The use of modern neuroimaging approaches has demonstrated resting-state regional cerebral blood flow (rCBF) to be tightly coupled to resting cerebral glucose metabolism (rCMRglu) in healthy brains. In schizophrenia, several lines of evidence point toward aberrant neurovascular coupling, especially in the prefrontal regions. To investigate this, we used Signed Differential Mapping to undertake a voxel-based bimodal meta-analysis examining the relationship between rCBF and rCMRglu in schizophrenia, as measured by arterial spin labeling (ASL) and 18Flurodeoxyglucose positron emission tomography (FDG-PET) respectively. We used 19 studies comprised of data from 557 patients and 584 controls. Our results suggest that several key regions implicated in the pathophysiology of schizophrenia such as the frontoinsular cortex, dorsal ACC, putamen, and temporal pole show conjoint metabolic and perfusion abnormalities in patients. In contrast, discordance between metabolism and perfusion were seen in superior frontal gyrus and cerebellum, indicating that factors contributing to neurovascular uncoupling (e.g. inflammation, mitochondrial dysfunction, oxidative stress) are likely operates at these loci. Studies enrolling patients on high doses of antipsychotics had showed larger rCBF/rCMRglu effects in patients in the left dorsal striatum. Hybrid ASL-PET studies focusing on these regions could confirm our proposition regarding neurovascular uncoupling at superior frontal gyrus in schizophrenia.
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Affiliation(s)
- Niron Sukumar
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | | | - Udunna Anazodo
- Lawson Health Research Institute, London, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
| | - Lena Palaniyappan
- Department of Psychiatry, University of Western Ontario, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Robarts Research Institute, University of Western Ontario, London, ON, Canada
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25
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Wannan CMJ, Cropley VL, Chakravarty MM, Van Rheenen TE, Mancuso S, Bousman C, Everall I, McGorry PD, Pantelis C, Bartholomeusz CF. Hippocampal subfields and visuospatial associative memory across stages of schizophrenia-spectrum disorder. Psychol Med 2019; 49:2452-2462. [PMID: 30511607 DOI: 10.1017/s0033291718003458] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND While previous studies have identified relationships between hippocampal volumes and memory performance in schizophrenia, these relationships are not apparent in healthy individuals. Further, few studies have examined the role of hippocampal subfields in illness-related memory deficits, and no study has examined potential differences across varying illness stages. The current study aimed to investigate whether individuals with early and established psychosis exhibited differential relationships between visuospatial associative memory and hippocampal subfield volumes. METHODS Measurements of visuospatial associative memory performance and grey matter volume were obtained from 52 individuals with a chronic schizophrenia-spectrum disorder, 28 youth with recent-onset psychosis, 52 older healthy controls, and 28 younger healthy controls. RESULTS Both chronic and recent-onset patients had impaired visuospatial associative memory performance, however, only chronic patients showed hippocampal subfield volume loss. Both chronic and recent-onset patients demonstrated relationships between visuospatial associative memory performance and hippocampal subfield volumes in the CA4/dentate gyrus and the stratum that were not observed in older healthy controls. There were no group by volume interactions when chronic and recent-onset patients were compared. CONCLUSIONS The current study extends the findings of previous studies by identifying particular hippocampal subfields, including the hippocampal stratum layers and the dentate gyrus, that appear to be related to visuospatial associative memory ability in individuals with both chronic and first-episode psychosis.
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Affiliation(s)
- Cassandra M J Wannan
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- The Cooperative Research Centre for Mental Health, Melbourne, Australia
- North Western Mental Health, Melbourne Health, Parkville, VIC, Australia
| | - Vanessa L Cropley
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Canada
- Departments of Psychiatry and Biological and Biomedical Engineering, McGill University, Montreal, Canada
| | - Tamsyn E Van Rheenen
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Sam Mancuso
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
| | - Chad Bousman
- Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Ian Everall
- The Cooperative Research Centre for Mental Health, Melbourne, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
- Department of Electrical and Electronic Engineering, Centre for Neural Engineering, University of Melbourne, South Carlton, Victoria, Australia
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
- Florey Institute for Neuroscience & Mental Health, Parkville, VIC, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- The Cooperative Research Centre for Mental Health, Melbourne, Australia
- North Western Mental Health, Melbourne Health, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
- Department of Electrical and Electronic Engineering, Centre for Neural Engineering, University of Melbourne, South Carlton, Victoria, Australia
- Florey Institute for Neuroscience & Mental Health, Parkville, VIC, Australia
| | - Cali F Bartholomeusz
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
- The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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26
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Abstract
The ability to mentalize, or theory of mind (ToM), is sexually dimorphic in humans and impaired in schizophrenia. This sex-stratified study probed cognitive (indexed by intelligence) and affective (indexed by olfactory tasks) contributions to ToM performance in 37 individuals with schizophrenia and 31 healthy controls. The schizophrenia group showed impairments in mental state identification and inferring intentions compared to controls. Higher intelligence was correlated with mental state identification and inferring intentions in healthy females, whereas better smell identification was associated with mental state identification in healthy males. Conversely, higher intelligence was associated with mental state identification and inferring intentions in schizophrenia males, while better smell identification was correlated with mental state identification in schizophrenia females. These findings suggest that for ToM circuitry, the cognitive influences in healthy females and affective influences in healthy males are reversed in schizophrenia and may be displaced to lower circuitries by disease pathology. Symptom associations with emotion and cognition are also dimorphic, plausibly due to similar pathology superimposed on normal sex-specific circuitries. Males appear to rely on limbic processing for ToM, and disruption to this circuitry may contribute to development of negative symptoms. These findings highlight the importance of utilizing sex-stratified designs in schizophrenia research.
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Affiliation(s)
- Julie Walsh-Messinger
- a Department of Psychology, University of Dayton , Dayton , OH , USA.,b Department of Psychiatry, Wright State University Boonshoft School of Medicine , Dayton , OH , USA
| | - Christine Stepanek
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Julia Wiedemann
- a Department of Psychology, University of Dayton , Dayton , OH , USA
| | - Deborah Goetz
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Raymond R Goetz
- d New York State Psychiatric Institute, Columbia University Medical Center , New York , NY , USA
| | - Dolores Malaspina
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
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27
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Egloff L, Lenz C, Studerus E, Harrisberger F, Smieskova R, Schmidt A, Huber C, Simon A, Lang UE, Riecher-Rössler A, Borgwardt S. Sexually dimorphic subcortical brain volumes in emerging psychosis. Schizophr Res 2018; 199:257-265. [PMID: 29605160 DOI: 10.1016/j.schres.2018.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/27/2018] [Accepted: 03/18/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND In schizophrenic psychoses, the normal sexual dimorphism of the brain has been shown to be disrupted or even reversed. Little is known, however, at what time point in emerging psychosis this occurs. We have therefore examined, if these alterations are already present in the at-risk mental state (ARMS) for psychosis and in first episode psychosis (FEP) patients. METHODS Data from 65 ARMS (48 (73.8%) male; age=25.1±6.32) and 50 FEP (37 (74%) male; age=27±6.56) patients were compared to those of 70 healthy controls (HC; 27 (38.6%) male; age=26±4.97). Structural T1-weighted images were acquired using a 3 Tesla magnetic resonance imaging (MRI) scanner. Linear mixed effects models were used to investigate whether subcortical brain volumes are dependent on sex. RESULTS We found men to have larger total brain volumes (p<0.001), and smaller bilateral caudate (p=0.008) and hippocampus volume (p<0.001) than women across all three groups. Older subjects had more GM and WM volume than younger subjects. No significant sex×group interaction was found. CONCLUSIONS In emerging psychosis there still seem to exist patterns of normal sexual dimorphism in total brain and caudate volume. The only structure affected by reversed sexual dimorphism was the hippocampus, with women showing larger volumes than men even in HC. Thus, we conclude that subcortical volumes may not be primarily affected by disrupted sexual dimorphism in emerging psychosis.
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Affiliation(s)
- Laura Egloff
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland; University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland
| | - Claudia Lenz
- University of Basel, Institute of Forensic Medicine, Basel, Switzerland
| | - Erich Studerus
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Fabienne Harrisberger
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Renata Smieskova
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - André Schmidt
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Christian Huber
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Andor Simon
- University Hospital of Bern, University Hospital of Psychiatry, Bern, Switzerland; Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, Bruderholz, Switzerland
| | - Undine E Lang
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Anita Riecher-Rössler
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland
| | - Stefan Borgwardt
- University of Basel Psychiatric Hospital, Department of Psychiatry, Basel, Switzerland.
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28
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Antoniades M, Schoeler T, Radua J, Valli I, Allen P, Kempton MJ, McGuire P. Verbal learning and hippocampal dysfunction in schizophrenia: A meta-analysis. Neurosci Biobehav Rev 2018; 86:166-175. [PMID: 29223768 PMCID: PMC5818020 DOI: 10.1016/j.neubiorev.2017.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 10/24/2017] [Accepted: 12/01/2017] [Indexed: 12/19/2022]
Abstract
This meta-analysis summarizes research examining whether deficits in verbal learning are related to bilateral hippocampal volume reductions in patients with or at risk for schizophrenia and in healthy controls. 17 studies with 755 patients with schizophrenia (SCZ), 232 Genetic High Risk (GHR) subjects and 914 healthy controls (HC) were included. Pooled correlation coefficients were calculated between hemisphere (left, right or total) and type of recall (immediate or delayed) for each diagnostic group individually (SCZ, GHR and HC). In SCZ, left and right hippocampal volume positively correlated with immediate (r=0.256, 0.230) and delayed (r=0.132, 0.231) verbal recall. There was also a correlation between total hippocampal volume and delayed recall (r=0.233). None of these correlations were significant in healthy controls. There was however, a positive correlation between left hippocampal volume and immediate recall in the GHR group (r=0.356). The results suggest that hippocampal volume affects immediate and delayed verbal learning capacity in schizophrenia and provides further evidence of hippocampal dysfunction in the pathophysiology of schizophrenia.
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Affiliation(s)
- Mathilde Antoniades
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Tabea Schoeler
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Joaquim Radua
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; FIDMAG Germanes Hospitalàries - CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Isabel Valli
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Paul Allen
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Department of Psychology, University of Roehampton, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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29
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Günther V, Lindner C, Dannlowski U, Kugel H, Suslow T. Amygdalar Gray Matter Volume and Social Relating in Schizophrenia. Neuropsychobiology 2018; 74:139-143. [PMID: 28441663 DOI: 10.1159/000458528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 01/31/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Poor social relating is a prominent feature of schizophrenia. The amygdala has been suggested as an important node in social brain networks. METHODS By using structural magnetic resonance imaging, this study examined, for the first time, the relationship between amygdalar gray matter (GM) volume and social relating in 35 schizophrenia patients. Social anhedonia, interaction anxiety, extraversion, and sociable tendencies were assessed as indices of social relating. RESULTS A correlation between GM volume in the amygdala and enhanced social relating was revealed. CONCLUSION These findings indicate that volumetric decreases in the amygdala are related to impoverished sociability in schizophrenia.
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Affiliation(s)
- Vivien Günther
- Department of Psychosomatic Medicine, University of Leipzig, Leipzig, Germany
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30
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Coccaro EF, Cremers H, Fanning J, Nosal E, Lee R, Keedy S, Jacobson KC. Reduced frontal grey matter, life history of aggression, and underlying genetic influence. Psychiatry Res Neuroimaging 2018; 271:126-134. [PMID: 29174436 DOI: 10.1016/j.pscychresns.2017.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 11/06/2017] [Accepted: 11/11/2017] [Indexed: 11/28/2022]
Abstract
Physically healthy, adult, same-sexed twins (n = 287) from a population-based twin cohort underwent high-resolution magnetic resonance imaging (MRI) to identify fronto-limbic brain regions significantly associated with lifetime history of aggression. MRI scans used a 3D magnetization-prepared rapid acquisition gradient-echo (MP-RAGE) sequence, for voxel-based morphometry (VBM) and history of aggressive behavior was assessed using the Life History of Aggression measure. Aggression had modest, inverse associations with grey matter volume (GMV) in medial prefrontal cortex (mPFC, b = -0.20, se = 0.05, p < 0.001) and lateral prefrontal cortex (lPFC, b = -0.23, se = 0.06, p < 0.001). These associations were not confounded by other demographic, psychiatric, or personality factors. Biometrical twin analyses revealed significant heritabilities of 0.57 for GMV in the mPFC cluster and 0.36 for GMV in the lPFC cluster. Genetic factors accounted for the majority of the phenotypic correlations between aggression and mPFC GMV (85.3%) and between aggression and lPFC GMV (63.7%). Reduced GMV of prefrontal brain regions may be a neuronal characteristic of individuals with substantial histories of aggressive behavior regardless of psychiatric diagnosis. As such, these data suggest an anatomical correlate, with a possible genetic etiology, associated with functional deficits in social-emotional information processing.
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Affiliation(s)
- Emil F Coccaro
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Henk Cremers
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Jennifer Fanning
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Eryka Nosal
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Royce Lee
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Sarah Keedy
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
| | - Kristen C Jacobson
- Clinical Neuroscience Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, Chicago 60637, IL, USA
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Koshiyama D, Fukunaga M, Okada N, Yamashita F, Yamamori H, Yasuda Y, Fujimoto M, Ohi K, Fujino H, Watanabe Y, Kasai K, Hashimoto R. Role of subcortical structures on cognitive and social function in schizophrenia. Sci Rep 2018; 8:1183. [PMID: 29352126 DOI: 10.1038/s41598-017-18950-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
Subcortical regions have a pivotal role in cognitive, affective, and social functions in humans, and the structural and functional abnormalities of the regions have been associated with various psychiatric disorders. Although previous studies focused on the neurocognitive and socio-functional consequences of prefrontal and tempolo-limbic abnormalities in psychiatric disorders, those of subcortical structures remain largely unknown. Recently, MRI volume alterations in subcortical structures in patients with schizophrenia have been replicated in large-scale meta-analytic studies. Here we investigated the relationship between volumes of subcortical structures and neurocognitive and socio-functional indices in a large sample of patients with schizophrenia. First, we replicated the results of meta-analyses: the regional volumes of the bilateral hippocampus, amygdala, thalamus and nucleus accumbens were significantly smaller for patients (N = 163) than for healthy controls (HCs, N = 620). Second, in the patient group, the right nucleus accumbens volume was significantly correlated with the Digit Symbol Coding score, which is known as a distinctively characteristic index of cognitive deficits in schizophrenia. Furthermore, the right thalamic volume was significantly correlated with social function scores. In HCs, no significant correlation was found. The results from this large-scale investigation shed light upon the role of specific subcortical nuclei on cognitive and social functioning in schizophrenia.
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Cahn W, Hulshoff Pol HE, Bongers M, Schnack HG, Mandl RCW, Van Haren NEM, Durston S, Koning H, Van Der Linden JA, Kahn RS. Brain morphology in antipsychotic-naïve schizophrenia: A study of multiple brain structures. Br J Psychiatry 2018; 43:s66-72. [PMID: 12271803 DOI: 10.1192/bjp.181.43.s66] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BackgroundAlthough brain volume changes are found in schizophrenia, only a limited number of structural magnetic resonance imaging studies have exclusively examined antipsychotic-naïve patients.AimsTo comprehensively investigate multiple brain structures in a single sample of patients who were antipsychotic-naïve.MethodTwenty antipsychotic-naïve patients with first-episode schizophrenia and 20 healthy comparison subjects were included. Intracranial, total brain, frontal lobe, grey and white matter, cerebellar, hippocampal, parahippocampal, thalamic, caudate nucleus and lateral and third ventricular volumes were measured. Repeated-measures analyses of (co)variance were conducted with intracranial volume as covariate.ResultsThird ventricle volume enlargement was found in patients compared with the healthy subjects. No differences were found in other brain regions.ConclusionsThese findings suggest that some brain abnormalities are present in the early stages of schizophrenia. Moreover, it suggests that brain abnormalities reported in patients with chronic schizophrenia develop in a later stage of the disease and/or are medication induced.
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Affiliation(s)
- W Cahn
- Department of Psychiatry, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
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Roalf DR, Nanga RPR, Rupert PE, Hariharan H, Quarmley M, Calkins ME, Dress E, Prabhakaran K, Elliott MA, Moberg PJ, Gur RC, Gur RE, Reddy R, Turetsky BI. Glutamate imaging (GluCEST) reveals lower brain GluCEST contrast in patients on the psychosis spectrum. Mol Psychiatry 2017; 22:1298-1305. [PMID: 28115738 PMCID: PMC5822706 DOI: 10.1038/mp.2016.258] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 10/19/2016] [Accepted: 12/06/2016] [Indexed: 01/05/2023]
Abstract
Psychosis commonly develops in adolescence or early adulthood. Youths at clinical high risk (CHR) for psychosis exhibit similar, subtle symptoms to those with schizophrenia (SZ). Malfunctioning neurotransmitter systems, such as glutamate, are implicated in the disease progression of psychosis. Yet, in vivo imaging techniques for measuring glutamate across the cortex are limited. Here, we use a novel 7 Tesla MRI glutamate imaging technique (GluCEST) to estimate changes in glutamate levels across cortical and subcortical regions in young healthy individuals and ones on the psychosis spectrum. Individuals on the psychosis spectrum (PS; n=19) and healthy young individuals (HC; n=17) underwent MRI imaging at 3 and 7 T. At 7 T, a single slice GluCEST technique was used to estimate in vivo glutamate. GluCEST contrast was compared within and across the subcortex, frontal, parietal and occipital lobes. Subcortical (χ2 (1)=4.65, P=0.031) and lobular (χ2 (1)=5.17, P=0.023) GluCEST contrast levels were lower in PS compared with HC. Abnormal GluCEST contrast levels were evident in both CHR (n=14) and SZ (n=5) subjects, and correlated differentially, across regions, with clinical symptoms. Our findings describe a pattern of abnormal brain neurochemistry early in the course of psychosis. Specifically, CHR and young SZ exhibit diffuse abnormalities in GluCEST contrast attributable to a major contribution from glutamate. We suggest that neurochemical profiles of GluCEST contrast across cortex and subcortex may be considered markers of early psychosis. GluCEST methodology thus shows promise to further elucidate the progression of the psychosis disease state.
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Affiliation(s)
- David R. Roalf
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Ravi Prakash Reddy Nanga
- Department of Radiology & Center for Magnetic and Optical Imaging, University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Petra E. Rupert
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Hari Hariharan
- Department of Radiology & Center for Magnetic and Optical Imaging, University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Megan Quarmley
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Monica E. Calkins
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Erich Dress
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Karthik Prabhakaran
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Mark A. Elliott
- Department of Radiology & Center for Magnetic and Optical Imaging, University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Paul J. Moberg
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Ruben C. Gur
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Ravinder Reddy
- Department of Radiology & Center for Magnetic and Optical Imaging, University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Bruce I. Turetsky
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania, Philadelphia PA 19104, USA
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Palaniyappan L. Progressive cortical reorganisation: A framework for investigating structural changes in schizophrenia. Neurosci Biobehav Rev 2017; 79:1-13. [DOI: 10.1016/j.neubiorev.2017.04.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 12/27/2022]
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Kalmady SV, Shivakumar V, Arasappa R, Subramaniam A, Gautham S, Venkatasubramanian G, Gangadhar BN. Clinical correlates of hippocampus volume and shape in antipsychotic-naïve schizophrenia. Psychiatry Res Neuroimaging 2017; 263:93-102. [PMID: 28371658 DOI: 10.1016/j.pscychresns.2017.03.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 03/09/2017] [Accepted: 03/20/2017] [Indexed: 01/25/2023]
Abstract
While volume deficit of hippocampus is an established finding in schizophrenia, very few studies have examined large sample of patients without the confounding effect of antipsychotic treatment. Concurrent evaluation of hippocampus shape will offer additional information on the hippocampal aberrations in schizophrenia. In this study, we analyzed the volume and shape of hippocampus in antipsychotic-naïve schizophrenia patients (N=71) in comparison to healthy controls (N=82). Using 3-T MRI data, gray matter (GM) volume (anterior and posterior sub-divisions) and shape of the hippocampus were analyzed. Schizophrenia patients had significant hippocampal GM volume deficits (specifically the anterior sub-division) in comparison to healthy controls. There were significant positive correlations between anterior hippocampus volume and psychopathology scores of positive syndrome. Shape analyses revealed significant inward deformation of bilateral hippocampal surface in patients. In conclusion, our study findings add robust support for volume deficit in hippocampus in antipsychotic-naïve schizophrenia. Hippocampal shape deficits in schizophrenia observed in this study map to anterior CA1 sub-region. The differential relationship of anterior hippocampus (but not posterior hippocampus) with clinical symptoms is in tune with the findings in animal models. Further systematic studies are needed to evaluate the relationship between these hippocampal gray matter deficits with white matter and functional connectivity to facilitate understanding the hippocampal network abnormalities in schizophrenia.
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Affiliation(s)
- Sunil Vasu Kalmady
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Rashmi Arasappa
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Aditi Subramaniam
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - S Gautham
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
| | - Bangalore N Gangadhar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Liu H, Li L, Shen L, Wang X, Hou Y, Zhao Z, Gu L, Mao J. Cavum septum pellucidum and first-episode psychosis: A meta-analysis. PLoS One 2017; 12:e0177715. [PMID: 28545119 PMCID: PMC5435239 DOI: 10.1371/journal.pone.0177715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/02/2017] [Indexed: 02/05/2023] Open
Abstract
Objectives To investigate the prevalence and changes of cavum septum pellucidum (CSP) in first-episode psychosis (FEP) patients. Methods Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify eligible studies comparing FEP patients and healthy controls from inception to Feb 29, 2016. Results Ten cross-sectional studies and three longitudinal studies reported in ten articles met our criteria. Our meta-analysis found no significant differences in the prevalence of either “any CSP” (OR = 1.41; 95% CI 0.90–2.20; p = 0.13; I2 = 52.7%) or “large CSP” (OR = 1.10; 95% CI 0.77–1.58; p = 0.59; I2 = 24.1%) between FEP patients and healthy controls. However, the heterogeneity analysis of the prevalence of “any CSP” suggested bias in outcome reporting. Conclusions The results based on current evidence suggest it is unclear whether “any CSP” is a risk factor for FEP due to the heterogeneity of the studies. There is insufficient evidence to support that “large CSP” is a possible risk factor for FEP.
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Affiliation(s)
- Hanwen Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Internal Medicine Unit, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ling Li
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Shen
- Department of Psychosomatic Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xianliang Wang
- Cardiovascular Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yazhu Hou
- Cardiovascular Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhiqiang Zhao
- Cardiovascular Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lili Gu
- Department of Medical Administration, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingyuan Mao
- Internal Medicine Unit, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- * E-mail:
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Ramirez-Carmona R, Garcia-Lazaro HG, Dominguez-Corrales B, Aguilar-Castañeda E, Roldan-Valadez E. Main effects and interactions of cerebral hemispheres, gender, and age in the calculation of volumes and asymmetries of selected structures of episodic memory. Funct Neurol 2017; 31:257-264. [PMID: 28072386 DOI: 10.11138/fneur/2016.31.4.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of this study was to clarify the influence of anatomical (cerebral hemisphere) and demographic (age and gender) variables on the gray matter (GM) volumes and volumetric asymmetry indices (VAIs) of selected structures involved in episodic memory. A cross-sectional study was performed in 47 healthy volunteers. Neuropsychological evaluation revealed similar IQs across the sample. Using SPM-based software, brain segmentation, labeling and volume measurements of the hippocampus, amygdala, middle temporal gyrus and parahippocampal gyrus were performed in each cerebral hemisphere. A two-way between-groups multivariate analysis of covariance (MANCOVA) was applied to GM volumes and VAIs. The main effects of gender and cerebral hemisphere on GM volumes were significant (p < .001), while there was no significant interaction effect between gender and cerebral hemisphere. VAI measurements showed a nonsignificant effect of gender, but a significant influence of age (p = .015). The linear model of interactions and main effects explained 33% of the variance influencing the GM volume quantification. While cerebral hemisphere and gender were found to affect the volumes of brain structures involved in episodic memory, the calculation of VAIs was affected only by age. A comprehensive understanding of the main effects and interaction effects of cerebral hemisphere, gender and age on the volumes and asymmetries of structures related to episodic memory might help neurologists, psychiatrists, geriatricians and other neuroscientists in the study of degenerative brain diseases.
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Altamura AC, Delvecchio G, Marotta G, Oldani L, Pigoni A, Ciappolino V, Caletti E, Rovera C, Dobrea C, Arici C, Benatti B, Camuri G, Prunas C, Paoli RA, Dell'osso B, Cinnante C, Triulzi FM, Brambilla P. Structural and metabolic differentiation between bipolar disorder with psychosis and substance-induced psychosis: An integrated MRI/PET study. Eur Psychiatry 2016; 41:85-94. [PMID: 28049086 DOI: 10.1016/j.eurpsy.2016.09.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/20/2016] [Accepted: 09/24/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) may be characterized by the presence of psychotic symptoms and comorbid substance abuse. In this context, structural and metabolic dysfunctions have been reported in both BD with psychosis and addiction, separately. In this study, we aimed at identifying neural substrates differentiating psychotic BD, with or without substance abuse, versus substance-induced psychosis (SIP) by coupling, for the first time, magnetic resonance imaging (MRI) and positron emission tomography (PET). METHODS Twenty-seven BD type I psychotic patients with (n=10) or without (n=17) substance abuse, 16 SIP patients and 54 healthy controls were enrolled in this study. 3T MRI and 18-FDG-PET scanning were acquired. RESULTS Gray matter (GM) volume and cerebral metabolism reductions in temporal cortices were observed in all patients compared to healthy controls. Moreover, a distinct pattern of fronto-limbic alterations were found in patients with substance abuse. Specifically, BD patients with substance abuse showed volume reductions in ventrolateral prefrontal cortex, anterior cingulate, insula and thalamus, whereas SIP patients in dorsolateral prefrontal cortex and posterior cingulate. Common alterations in cerebellum, parahippocampus and posterior cingulate were found in both BD with substance abuse and SIP. Finally, a unique pattern of GM volumes reduction, with concomitant increased of striatal metabolism, were observed in SIP patients. CONCLUSIONS These findings contribute to shed light on the identification of common and distinct neural markers associated with bipolar psychosis and substance abuse. Future longitudinal studies should explore the effect of single substances of abuse in patients at the first-episode of BD and substance-induced psychosis.
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Affiliation(s)
- A C Altamura
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Delvecchio
- Scientific Institute IRCCS "E. Medea", San Vito al Tagliamento (PN), Italy
| | - G Marotta
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Oldani
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A Pigoni
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - V Ciappolino
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - E Caletti
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Rovera
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Dobrea
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Arici
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Benatti
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - G Camuri
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - C Prunas
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - R A Paoli
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Dell'osso
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry, Bipolar Disorders Clinic, Stanford University, CA, USA
| | - C Cinnante
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F M Triulzi
- Department of Services, Neuroradiology Unit, Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Institute of Psychiatry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Neurosciences, University of Texas at Houston, Houston, TX, USA.
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Agarwal P, Sarris CE, Herschman Y, Agarwal N, Mammis A. Schizophrenia and neurosurgery: A dark past with hope of a brighter future. J Clin Neurosci 2016; 34:53-8. [DOI: 10.1016/j.jocn.2016.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 07/05/2016] [Accepted: 08/10/2016] [Indexed: 12/11/2022]
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Crum WR, Danckaers F, Huysmans T, Cotel MC, Natesan S, Modo MM, Sijbers J, Williams SCR, Kapur S, Vernon AC. Chronic exposure to haloperidol and olanzapine leads to common and divergent shape changes in the rat hippocampus in the absence of grey-matter volume loss. Psychol Med 2016; 46:3081-3093. [PMID: 27516217 PMCID: PMC5108303 DOI: 10.1017/s0033291716001768] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 06/23/2016] [Accepted: 06/23/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND One of the most consistently reported brain abnormalities in schizophrenia (SCZ) is decreased volume and shape deformation of the hippocampus. However, the potential contribution of chronic antipsychotic medication exposure to these phenomena remains unclear. METHOD We examined the effect of chronic exposure (8 weeks) to clinically relevant doses of either haloperidol (HAL) or olanzapine (OLZ) on adult rat hippocampal volume and shape using ex vivo structural MRI with the brain retained inside the cranium to prevent distortions due to dissection, followed by tensor-based morphometry (TBM) and elastic surface-based shape deformation analysis. The volume of the hippocampus was also measured post-mortem from brain tissue sections in each group. RESULTS Chronic exposure to either HAL or OLZ had no effect on the volume of the hippocampus, even at exploratory thresholds, which was confirmed post-mortem. In contrast, shape deformation analysis revealed that chronic HAL and OLZ exposure lead to both common and divergent shape deformations (q = 0.05, FDR-corrected) in the rat hippocampus. In particular, in the dorsal hippocampus, HAL exposure led to inward shape deformation, whereas OLZ exposure led to outward shape deformation. Interestingly, outward shape deformations that were common to both drugs occurred in the ventral hippocampus. These effects remained significant after controlling for hippocampal volume suggesting true shape changes. CONCLUSIONS Chronic exposure to either HAL or OLZ leads to both common and divergent effects on rat hippocampal shape in the absence of volume change. The implications of these findings for the clinic are discussed.
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Affiliation(s)
- W. R. Crum
- Department of Neuroimaging,
King's College London, Institute of
Psychiatry, Psychology and Neuroscience,
Centre for Neuroimaging Sciences, De Crespigny
Park, London, UK
| | - F. Danckaers
- Department of Physics,
iMinds-Vision Laboratory, University of
Antwerp, Antwerp, Belgium
| | - T. Huysmans
- Department of Physics,
iMinds-Vision Laboratory, University of
Antwerp, Antwerp, Belgium
| | - M.-C. Cotel
- Department of Psychosis Studies,
King's College London, Institute of
Psychiatry, Psychology and Neuroscience, De
Crespigny Park, London, UK
| | - S. Natesan
- Department of Psychosis Studies,
King's College London, Institute of
Psychiatry, Psychology and Neuroscience, De
Crespigny Park, London, UK
| | - M. M. Modo
- Department of Basic and Clinical
Neuroscience, King's College London,
Institute of Psychiatry, Psychology and
Neuroscience, Maurice Wohl Institute for Clinical
Neuroscience, London, UK
| | - J. Sijbers
- Department of Physics,
iMinds-Vision Laboratory, University of
Antwerp, Antwerp, Belgium
| | - S. C. R. Williams
- Department of Neuroimaging,
King's College London, Institute of
Psychiatry, Psychology and Neuroscience,
Centre for Neuroimaging Sciences, De Crespigny
Park, London, UK
| | - S. Kapur
- Department of Psychosis Studies,
King's College London, Institute of
Psychiatry, Psychology and Neuroscience, De
Crespigny Park, London, UK
| | - A. C. Vernon
- Department of Psychosis Studies,
King's College London, Institute of
Psychiatry, Psychology and Neuroscience, De
Crespigny Park, London, UK
- Department of Basic and Clinical
Neuroscience, King's College London,
Institute of Psychiatry, Psychology and
Neuroscience, Maurice Wohl Institute for Clinical
Neuroscience, London, UK
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41
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Abstract
Fast mapping (FM), a process that promotes the expeditious incidental learning of information, is thought to support rapid vocabulary acquisition in young children through extra-medial temporal lobe (MTL) regions. A recent study suggested that patients with MTL damage resulting in profound amnesia were able to learn novel word–image associations using an FM paradigm. The present study investigated whether FM would be an effective strategy to promote learning for individuals with schizophrenia, a severe mental illness associated with compromised MTL functionality. Twenty-five patients with schizophrenia and 27 healthy control subjects completed trials of incidental FM encoding (experimental condition) and explicit encoding (EE, control condition) over the course of three visits spaced one week (± 2 days) apart. All participants were evaluated for recognition 10 min after each encoding condition was presented, and again one week (± 2 days) later. Results indicate that both groups performed better on the EE recognition trials when compared to FM (p's < 0.05). For the FM recognition trials, both groups performed similarly. However, participants with schizophrenia performed significantly worse on the EE recognition trials than healthy control participants (p's < 0.05). While participants with schizophrenia did not perform significantly worse when assessed for FM recognition, these results do not provide enough evidence to suggest that FM facilitates learning to a greater extent in schizophrenia when compared to EE. Whether FM may benefit a subgroup of patients with schizophrenia remains a focus of further investigation.
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Affiliation(s)
- Stephanie A. Korenic
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Sarah J. Nisonger
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Benjamin W. Krause
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - S. Andrea Wijtenburg
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - L. Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine
| | - Laura M. Rowland
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine
- Department of Psychology, University of Maryland Baltimore County
- Corresponding author at: Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD, 21228. Tel.: + 1 410 402 6803; fax: + 1 410 402 6077.Maryland Psychiatric Research CenterP.O. Box 21247BaltimoreMD21228
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42
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Seow LSE, Ong C, Mahesh MV, Sagayadevan V, Shafie S, Chong SA, Subramaniam M. A systematic review on comorbid post-traumatic stress disorder in schizophrenia. Schizophr Res 2016; 176:441-451. [PMID: 27230289 DOI: 10.1016/j.schres.2016.05.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 05/05/2016] [Accepted: 05/05/2016] [Indexed: 12/21/2022]
Abstract
Post-traumatic stress disorder (PTSD) appears to commonly co-occur with schizophrenia, which is widely considered the most disabling mental illness. Both conditions share neurological risk factors, and present with symptoms that are superficially similar, complicating diagnostic accuracy. The presence of comorbid PTSD is also of concern as additional diagnoses tend to worsen functioning and quality of life. In the current review, EMBASE, Medline, and PsycINFO were searched for articles pertaining to PTSD comorbidity in schizophrenia spectrum disorders. Articles went through two stages of review prior to inclusion - one at the abstract level and another at the full-text level. Thirty-four articles were ultimately included in the present review. Prevalence of PTSD in schizophrenia ranged from 0 to 57%, likely due to study heterogeneity. Findings generally indicated that comorbid PTSD was associated with higher levels of positive symptoms, general psychopathology, and neurocognitive impairment, as well as worse functioning and quality of life. As such, it is important for clinicians to differentiate between psychotic and PTSD symptoms, and to pay attention to the associated features of comorbid PTSD in order to provide the most appropriate intervention. Unfortunately, epidemiological and longitudinal studies in this area are lacking.
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Affiliation(s)
| | - Clarissa Ong
- Research Division, Institute of Mental Health, Singapore
| | | | | | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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43
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Sun Y, Zhang L, Ancharaz SS, Cheng S, Sun W, Wang H, Sun Y. Decreased fractional anisotropy values in two clusters of white matter in patients with schizotypal personality disorder: A DTI study. Behav Brain Res 2016; 310:68-75. [DOI: 10.1016/j.bbr.2016.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/16/2016] [Accepted: 05/09/2016] [Indexed: 11/24/2022]
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44
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Abstract
Anxiety symptoms can occur in up to 65 % of patients with schizophrenia, and may reach the threshold for diagnosis of various comorbid anxiety disorders, including obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). We review the clinical presentation, diagnosis, neurobiology, and management of anxiety in patients with schizophrenia, with a particular focus on pharmacotherapy. The prevalence of any anxiety disorder (at syndrome level) in schizophrenia is estimated to be up to 38 %, with social anxiety disorder (SAD) being the most prevalent. Severity of positive symptoms may correlate with severity of anxiety symptoms, but anxiety can occur independently of psychotic symptoms. While anxiety may be associated with greater levels of insight, it is also associated with increased depression, suicidality, medical service utilization, and cognitive impairment. Patients with anxiety symptoms are more likely to have other internalizing symptoms as opposed to externalizing symptoms. Diagnosis of anxiety in schizophrenia may be challenging, with positive symptoms obscuring anxiety, lower levels of emotional expressivity and communication impeding diagnosis, and conflation with akathisia. Higher diagnostic yield may be achieved by assessment following the resolution of the acute phase of psychosis as well as by the use of screening questions and disorder-specific self-report instruments. In schizophrenia patients with anxiety, there is evidence of underactive fear circuitry during anxiety-provoking stimuli but increased autonomic responsivity and increased responsiveness to neutral stimuli. Recent findings implicate the serotonin transporter (SERT) genes, brain-derived neurotropic factor (BDNF) genes, and the serotonin 1a (5HT1a) receptor, but are preliminary and in need of replication. There are few randomized controlled trials (RCTs) of psychotherapy for anxiety symptoms or disorders in schizophrenia. For pharmacotherapy, data from a few randomized and open trials have shown that aripiprazole and risperidone may be efficacious for obsessive-compulsive and social anxiety symptoms, and quetiapine and olanzapine for generalized anxiety. Older agents such as trifluoperazine may also reduce comorbid anxiety symptoms. Alternative options include selective serotonin re-uptake inhibitor (SSRI) augmentation of antipsychotics, although evidence is based on a few randomized trials, small open trials, and case series, and caution is needed with regards to cytochrome P450 interactions and QTc interval prolongation. Buspirone and pregabalin augmentation may also be considered. Diagnosis and treatment of anxiety symptoms and disorders in schizophrenia is an important and often neglected aspect of the management of schizophrenia.
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Affiliation(s)
- Henk Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Education Centre, Valkenberg Hospital, Private Bag X1, Observatory, Cape Town, 7935, South Africa.
| | - Dan J Stein
- Department of Psychiatry and Mental Health, MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Groote Schuur Hospital (J-2), Anzio Rd, Observatory, Cape Town, 7925, South Africa
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45
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Kandola A, Hendrikse J, Lucassen PJ, Yücel M. Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment. Front Hum Neurosci 2016; 10:373. [PMID: 27524962 PMCID: PMC4965462 DOI: 10.3389/fnhum.2016.00373] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/11/2016] [Indexed: 12/24/2022] Open
Abstract
Aerobic exercise (AE) has been widely praised for its potential benefits to cognition and overall brain and mental health. In particular, AE has a potent impact on promoting the function of the hippocampus and stimulating neuroplasticity. As the evidence-base rapidly builds, and given most of the supporting work can be readily translated from animal models to humans, the potential for AE to be applied as a therapeutic or adjunctive intervention for a range of human conditions appears ever more promising. Notably, many psychiatric and neurological disorders have been associated with hippocampal dysfunction, which may underlie the expression of certain symptoms common to these disorders, including (aspects of) cognitive dysfunction. Augmenting existing treatment approaches using AE based interventions may promote hippocampal function and alleviate cognitive deficits in various psychiatric disorders that currently remain untreated. Incorporating non-pharmacological interventions into clinical treatment may also have a number of other benefits to patient well being, such as limiting the risk of adverse side effects. This review incorporates both animal and human literature to comprehensively detail how AE is associated with cognitive enhancements and stimulates a cascade of neuroplastic mechanisms that support improvements in hippocampal functioning. Using the examples of schizophrenia and major depressive disorder, the utility and implementation of an AE intervention to the clinical domain will be proposed, aimed to reduce cognitive deficits in these, and related disorders.
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Affiliation(s)
- Aaron Kandola
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, MelbourneVIC, Australia; Amsterdam Brain and Cognition, University of AmsterdamAmsterdam, Netherlands
| | - Joshua Hendrikse
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne VIC, Australia
| | - Paul J Lucassen
- Centre for Neuroscience, Swammerdam Institute of Life Sciences, University of Amsterdam Amsterdam, Netherlands
| | - Murat Yücel
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne VIC, Australia
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46
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Abstract
OBJECTIVE The molecular and cellular basis of structural and functional abnormalities of the hippocampus found in schizophrenia is currently unclear. Postnatal neurogenesis contributes to hippocampal function in animal models and is correlated with hippocampal volume in primates. Reduced hippocampal cell proliferation has been previously reported in schizophrenia, which may contribute to hippocampal dysfunction. METHOD We measured the cell proliferation marker, Ki67, in post-mortem hippocampal tissue from patients with schizophrenia (n = 10) and matched controls (n = 16). Ki67-labelled cells were counted within the dentate gyrus and hilus on sections taken from the anterior hippocampus. RESULTS We replicated the finding of a significant reduction in Ki67+ cells/mm² in schizophrenia cases compared to controls (t24 = 2.1, p = 0.023). In our relatively small sample, we did not find a relationship between Ki67+ cells and age overall, or between Ki67 + cells and duration of illness or antipsychotic treatment in people with schizophrenia. CONCLUSION Our results confirm that reduced hippocampal cell proliferation may be present in schizophrenia. Restoring hippocampal neurogenesis may be a potential therapeutic target for the treatment of hippocampal dysfunction in schizophrenia.
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Affiliation(s)
- Katherine M Allen
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Samantha J Fung
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Cynthia Shannon Weickert
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia,Neuroscience Research Australia, Randwick, NSW, Australia,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia,Cynthia Shannon Weickert, Neuroscience Research Australia, Corner of Barker and Easy Streets, Randwick, Sydney, NSW 2031, Australia.
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47
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Satterthwaite TD, Wolf DH, Calkins ME, Vandekar SN, Erus G, Ruparel K, Roalf DR, Linn KA, Elliott MA, Moore TM, Hakonarson H, Shinohara RT, Davatzikos C, Gur RC, Gur RE. Structural Brain Abnormalities in Youth With Psychosis Spectrum Symptoms. JAMA Psychiatry 2016; 73:515-24. [PMID: 26982085 PMCID: PMC5048443 DOI: 10.1001/jamapsychiatry.2015.3463] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Structural brain abnormalities are prominent in psychotic disorders, including schizophrenia. However, it is unclear when aberrations emerge in the disease process and if such deficits are present in association with less severe psychosis spectrum (PS) symptoms in youth. OBJECTIVE To investigate the presence of structural brain abnormalities in youth with PS symptoms. DESIGN, SETTING, AND PARTICIPANTS The Philadelphia Neurodevelopmental Cohort is a prospectively accrued, community-based sample of 9498 youth who received a structured psychiatric evaluation. A subsample of 1601 individuals underwent neuroimaging, including structural magnetic resonance imaging, at an academic and children's hospital health care network between November 1, 2009, and November 30, 2011. MAIN OUTCOMES AND MEASURES Measures of brain volume derived from T1-weighted structural neuroimaging at 3 T. Analyses were conducted at global, regional, and voxelwise levels. Regional volumes were estimated with an advanced multiatlas regional segmentation procedure, and voxelwise volumetric analyses were conducted as well. Nonlinear developmental patterns were examined using penalized splines within a general additive model. Psychosis spectrum (PS) symptom severity was summarized using factor analysis and evaluated dimensionally. RESULTS Following exclusions due to comorbidity and image quality assurance, the final sample included 791 participants aged youth 8 to 22 years. Fifty percent (n = 393) were female. After structured interviews, 391 participants were identified as having PS features (PS group) and 400 participants were identified as typically developing comparison individuals without significant psychopathology (TD group). Compared with the TD group, the PS group had diminished whole-brain gray matter volume (P = 1.8 × 10-10) and expanded white matter volume (P = 2.8 × 10-11). Voxelwise analyses revealed significantly lower gray matter volume in the medial temporal lobe (maximum z score = 5.2 and cluster size of 1225 for the right and maximum z score = 4.5 and cluster size of 310 for the left) as well as in frontal, temporal, and parietal cortex. Volumetric reduction in the medial temporal lobe was correlated with PS symptom severity. CONCLUSIONS AND RELEVANCE Structural brain abnormalities that have been commonly reported in adults with psychosis are present early in life in youth with PS symptoms and are not due to medication effects. Future longitudinal studies could use the presence of such abnormalities in conjunction with clinical presentation, cognitive profile, and genomics to predict risk and aid in stratification to guide early interventions.
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Affiliation(s)
| | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Simon N Vandekar
- Department of Biostatistics and Clinical Epidemiology, University of Pennsylvania, Philadelphia
| | - Guray Erus
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - David R Roalf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kristin A Linn
- Department of Biostatistics and Clinical Epidemiology, University of Pennsylvania, Philadelphia
| | - Mark A Elliott
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Hakon Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Russell T Shinohara
- Department of Biostatistics and Clinical Epidemiology, University of Pennsylvania, Philadelphia
| | | | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia3Department of Radiology, University of Pennsylvania, Philadelphia
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia3Department of Radiology, University of Pennsylvania, Philadelphia
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48
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Lee SH, Niznikiewicz M, Asami T, Otsuka T, Salisbury DF, Shenton ME, McCarley RW. Initial and Progressive Gray Matter Abnormalities in Insular Gyrus and Temporal Pole in First-Episode Schizophrenia Contrasted With First-Episode Affective Psychosis. Schizophr Bull 2016; 42:790-801. [PMID: 26675295 PMCID: PMC4838098 DOI: 10.1093/schbul/sbv177] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although the insula and temporal pole (TP) of paralimbic regions are important in both affective and cognitive processing, it is not well known whether gray matter volume (GMV) abnormalities in these regions show post-onset progression and differentially affect first-episode schizophrenia (FESZ) and first-episode affective psychosis (FEAFF) patients. To determine whether there are initial and progressive GMV deficits in insula and TP in FESZ and FEAFF (mainly manic) patients, their relative specificity to FESZ or FEAFF, and relationship to symptoms, we conducted a naturalistic study at first hospitalization for psychosis and follow-up ~1.5 years later. Initial 1.5T magnetic resonance imaging (MRI) scans and follow-up scans were on the same scanner. Twenty-two FESZ, 23 FEAFF, and 23 healthy control (HC) subjects were group matched for age, gender, parental socioeconomic status, and handedness. At first hospitalization, FESZ showed significantly smaller bilateral insular GMV compared with FEAFF, and smaller left TP GMV compared with FEAFF and HC. Moreover, on 1.5 years follow-up, FESZ showed progressive GMV decreases in bilateral insula compared with FEAFF and HC, and in TP GMV compared with HC. In contrast, FEAFF showed no progression. Progression of FESZ GMV in both insula and TP was inversely associated with changes in the overall Brief Psychiatric Rating Scale symptom score, indicating less improvement or worsening of symptoms.
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Affiliation(s)
| | - Margaret Niznikiewicz
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA;,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Takeshi Asami
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA;,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Tatsui Otsuka
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA;,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Dean F. Salisbury
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA;,Clinical Neurophysiology Research Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Martha E. Shenton
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA;,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Robert W. McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA;,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;,*To whom correspondence should be addressed; Department of Psychiatry, 116A, VA Boston Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., Brockton, MA 02301, US; tel: 508-583-4500-X63723 or X62473, fax: 508-586-0894, e-mail:
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49
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Rich AM, Cho YT, Tang Y, Savic A, Krystal JH, Wang F, Xu K, Anticevic A. Amygdala volume is reduced in early course schizophrenia. Psychiatry Res 2016; 250:50-60. [PMID: 27035063 PMCID: PMC4904038 DOI: 10.1016/j.pscychresns.2016.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 02/01/2016] [Accepted: 02/11/2016] [Indexed: 02/07/2023]
Abstract
Subcortical structural alterations have been implicated in the neuropathology of schizophrenia. Yet, the extent of anatomical alterations for subcortical structures across illness phases remains unknown. To assess this, magnetic resonance imaging (MRI) was used to examine volume differences of major subcortical structures: thalamus, nucleus accumbens, caudate, putamen, globus pallidus, amygdala and hippocampus. These differences were examined across four groups: (i) healthy comparison subjects (HCS, n=96); (ii) individuals at high risk (HR, n=21) for schizophrenia; (iii) early-course schizophrenia patients (EC-SCZ, n=28); and (iv) chronic schizophrenia patients (C-SCZ, n=20). Raw gray matter volumes and volumetric ratios (volume of specific structure/total gray matter volume) were extracted using automated segmentation tools. EC-SCZ group exhibited smaller bilateral amygdala volumetric ratios, compared to HCS and HR subjects. Findings did not change when corrected for age, level of education and medication use. Amygdala raw volumes did not differ among groups once adjusted for multiple comparisons, but the smaller amygdala volumetric ratio in EC-SCZ survived Bonferroni correction. Other structures were not different across the groups following Bonferroni correction. Smaller amygdala volumes during early illness course may reflect pathophysiologic changes specific to illness development, including disrupted salience processing and acute stress responses.
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Affiliation(s)
- Alyson M Rich
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA; College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI 48109, USA
| | - Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Aleksandar Savic
- University Psychiatric Hospital Vrapce, University of Zagreb, Zagreb 10000, Croatia
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT 06519, USA; NIAAA Center for the Translational Neuroscience of Alcoholism, New Haven, CT 06519, USA
| | - Fei Wang
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA; Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China
| | - Ke Xu
- Department of Radiology, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China.
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA; Department of Psychiatry, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, PR China; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT 06519, USA; NIAAA Center for the Translational Neuroscience of Alcoholism, New Haven, CT 06519, USA; Department of Psychology, Yale University, 2 Hillhouse Avenue, CT 06520, USA; Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520, USA.
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50
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Valli I, Marquand AF, Mechelli A, Raffin M, Allen P, Seal ML, McGuire P. Identifying Individuals at High Risk of Psychosis: Predictive Utility of Support Vector Machine using Structural and Functional MRI Data. Front Psychiatry 2016; 7:52. [PMID: 27092086 PMCID: PMC4824756 DOI: 10.3389/fpsyt.2016.00052] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/23/2016] [Indexed: 01/20/2023] Open
Abstract
The identification of individuals at high risk of developing psychosis is entirely based on clinical assessment, associated with limited predictive potential. There is, therefore, increasing interest in the development of biological markers that could be used in clinical practice for this purpose. We studied 25 individuals with an at-risk mental state for psychosis and 25 healthy controls using structural MRI, and functional MRI in conjunction with a verbal memory task. Data were analyzed using a standard univariate analysis, and with support vector machine (SVM), a multivariate pattern recognition technique that enables statistical inferences to be made at the level of the individual, yielding results with high translational potential. The application of SVM to structural MRI data permitted the identification of individuals at high risk of psychosis with a sensitivity of 68% and a specificity of 76%, resulting in an accuracy of 72% (p < 0.001). Univariate volumetric between-group differences did not reach statistical significance. By contrast, the univariate fMRI analysis identified between-group differences (p < 0.05 corrected), while the application of SVM to the same data did not. Since SVM is well suited at identifying the pattern of abnormality that distinguishes two groups, whereas univariate methods are more likely to identify regions that individually are most different between two groups, our results suggest the presence of focal functional abnormalities in the context of a diffuse pattern of structural abnormalities in individuals at high clinical risk of psychosis.
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Affiliation(s)
- Isabel Valli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Andre F Marquand
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands; Centre for Neuroimaging Sciences, King's College London, London, UK
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Marie Raffin
- Service de Psychiatrie de l'enfant et de l'adolescent, CHU Pitié-Salpêtrière , Paris , France
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
| | - Marc L Seal
- Developmental Imaging Research Group, Murdoch Children Research Institute, University of Melbourne , Melbourne, VIC , Australia
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK
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