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Messina A, Cuccì G, Crescimanno C, Signorelli MS. Clinical anatomy of the precuneus and pathogenesis of the schizophrenia. Anat Sci Int 2023:10.1007/s12565-023-00730-w. [PMID: 37340095 DOI: 10.1007/s12565-023-00730-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/12/2023] [Indexed: 06/22/2023]
Abstract
Recent evidence has shown that the precuneus plays a role in the pathogenesis of schizophrenia. The precuneus is a structure of the parietal lobe's medial and posterior cortex, representing a central hub involved in multimodal integration processes. Although neglected for several years, the precuneus is highly complex and crucial for multimodal integration. It has extensive connections with different cerebral areas and is an interface between external stimuli and internal representations. In human evolution, the precuneus has increased in size and complexity, allowing the development of higher cognitive functions, such as visual-spatial ability, mental imagery, episodic memory, and other tasks involved in emotional processing and mentalization. This paper reviews the functions of the precuneus and discusses them concerning the psychopathological aspects of schizophrenia. The different neuronal circuits, such as the default mode network (DMN), in which the precuneus is involved and its alterations in the structure (grey matter) and the disconnection of pathways (white matter) are described.
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Affiliation(s)
- Antonino Messina
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy.
| | | | | | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
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Hua JPY, Cummings J, Roach BJ, Fryer SL, Loewy RL, Stuart BK, Ford JM, Vinogradov S, Mathalon DH. Rich-club connectivity and structural connectome organization in youth at clinical high-risk for psychosis and individuals with early illness schizophrenia. Schizophr Res 2023; 255:110-121. [PMID: 36989668 PMCID: PMC10705845 DOI: 10.1016/j.schres.2023.03.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 11/07/2022] [Accepted: 03/08/2023] [Indexed: 03/31/2023]
Abstract
Brain dysconnectivity has been posited as a biological marker of schizophrenia. Emerging schizophrenia connectome research has focused on rich-club organization, a tendency for brain hubs to be highly-interconnected but disproportionately vulnerable to dysconnectivity. However, less is known about rich-club organization in individuals at clinical high-risk for psychosis (CHR-P) and how it compares with abnormalities early in schizophrenia (ESZ). Combining diffusion tensor imaging (DTI) and magnetic resonance imaging (MRI), we examined rich-club and global network organization in CHR-P (n = 41) and ESZ (n = 70) relative to healthy controls (HC; n = 74) after accounting for normal aging. To characterize rich-club regions, we examined rich-club MRI morphometry (thickness, surface area). We also examined connectome metric associations with symptom severity, antipsychotic dosage, and in CHR-P specifically, transition to a full-blown psychotic disorder. ESZ had fewer connections among rich-club regions (ps < .024) relative to HC and CHR-P, with this reduction specific to the rich-club even after accounting for other connections in ESZ relative to HC (ps < .048). There was also cortical thinning of rich-club regions in ESZ (ps < .013). In contrast, there was no strong evidence of global network organization differences among the three groups. Although connectome abnormalities were not present in CHR-P overall, CHR-P converters to psychosis (n = 9) had fewer connections among rich-club regions (ps < .037) and greater modularity (ps < .037) compared to CHR-P non-converters (n = 19). Lastly, symptom severity and antipsychotic dosage were not significantly associated with connectome metrics (ps < .012). Findings suggest that rich-club and connectome organization abnormalities are present early in schizophrenia and in CHR-P individuals who subsequently transition to psychosis.
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Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center and the University of California, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Jennifer Cummings
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Brian J Roach
- San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Susanna L Fryer
- San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Barbara K Stuart
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Judith M Ford
- San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Daniel H Mathalon
- San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA.
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Percie du Sert O, Unrau J, Gauthier CJ, Chakravarty M, Malla A, Lepage M, Raucher-Chéné D. Cerebral blood flow in schizophrenia: A systematic review and meta-analysis of MRI-based studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 121:110669. [PMID: 36341843 DOI: 10.1016/j.pnpbp.2022.110669] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 10/19/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Schizophrenia-spectrum disorders (SSD) represent one of the leading causes of disability worldwide and are usually underpinned by neurodevelopmental brain abnormalities observed on a structural and functional level. Nuclear medicine imaging studies of cerebral blood flow (CBF) have already provided insights into the pathophysiology of these disorders. Recent developments in non-invasive MRI techniques such as arterial spin labeling (ASL) have allowed broader examination of CBF across SSD prompting us to conduct an updated literature review of MRI-based perfusion studies. In addition, we conducted a focused meta-analysis of whole brain studies to provide a complete picture of the literature on the topic. METHODS A systematic OVID search was performed in Embase, MEDLINEOvid, and PsycINFO. Studies eligible for inclusion in the review involved: 1) individuals with SSD, first-episode psychosis or clinical-high risk for psychosis, or; 2) had healthy controls for comparison; 3) involved MRI-based perfusion imaging methods; and 4) reported CBF findings. No time span was specified for the database queries (last search: 08/2022). Information related to participants, MRI techniques, CBF analyses, and results were systematically extracted. Whole-brain studies were then selected for the meta-analysis procedure. The methodological quality of each included studies was assessed. RESULTS For the systematic review, the initial Ovid search yielded 648 publications of which 42 articles were included, representing 3480 SSD patients and controls. The most consistent finding was that negative symptoms were linked to cortical fronto-limbic hypoperfusion while positive symptoms seemed to be associated with hyperperfusion, notably in subcortical structures. The meta-analysis integrated results from 13 whole-brain studies, across 426 patients and 401 controls, and confirmed the robustness of the hypoperfusion in the left superior and middle frontal gyri and right middle occipital gyrus while hyperperfusion was found in the left putamen. CONCLUSION This updated review of the literature supports the implication of hemodynamic correlates in the pathophysiology of psychosis symptoms and disorders. A more systematic exploration of brain perfusion could complete the search of a multimodal biomarker of SSD.
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Affiliation(s)
- Olivier Percie du Sert
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Joshua Unrau
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Claudine J Gauthier
- Concordia University, Montreal, QC, Canada; Montreal Heart Institute, Montreal, QC, Canada
| | - Mallar Chakravarty
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Ashok Malla
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Martin Lepage
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - Delphine Raucher-Chéné
- McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada; University of Reims Champagne-Ardenne, Cognition, Health, and Society Laboratory (EA 6291), Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
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Zhao L, Bo Q, Zhang Z, Chen Z, Wang Y, Zhang D, Li T, Yang N, Zhou Y, Wang C. Altered Dynamic Functional Connectivity in Early Psychosis Between the Salience Network and Visual Network. Neuroscience 2022; 491:166-175. [DOI: 10.1016/j.neuroscience.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
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Rikandi E, Mäntylä T, Lindgren M, Kieseppä T, Suvisaari J, Raij TT. Functional network connectivity and topology during naturalistic stimulus is altered in first-episode psychosis. Schizophr Res 2022; 241:83-91. [PMID: 35092893 DOI: 10.1016/j.schres.2022.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/28/2021] [Revised: 01/01/2022] [Accepted: 01/02/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Psychotic disorders have been suggested to derive from dysfunctional integration of signaling between brain regions. Earlier studies have found several changes in functional network synchronization as well as altered network topology in patients with psychotic disorders. However, studies have used mainly resting-state that makes it more difficult to link functional alterations to any specific stimulus or experience. We set out to examine functional connectivity as well as graph (topological) measures and their association to symptoms in first-episode psychosis patients during movie viewing. Our goal was to understand whole-brain functional dynamics of complex naturalistic information processing in psychosis and changes in brain functional organization related to symptoms. METHODS 71 first-episode psychosis patients and 57 control subjects watched scenes from the movie Alice in Wonderland during 3 T fMRI. We compared functional connectivity and graph measures indicating integration, segregation and centrality between groups, and examined the association between topology and symptom scores in the patient group. RESULTS We identified a subnetwork with predominantly decreased links of functional connectivity in first-episode psychosis patients. The subnetwork was mainly comprised of nodes of and links between the cingulo-opercular, sensorimotor and default-mode networks. In topological measures, we observed between-group differences in properties of centrality. CONCLUSIONS Functional brain networks are affected during naturalistic information processing already in the early stages of psychosis, concentrated in salience- and cognitive control-related hubs and subnetworks. Understanding these aberrant dynamics could add to better targeted cognitive and behavioral interventions in the early stages of psychotic disorders.
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Li JY, Wu H, Yuan S, Wang C, Wang Q, Zhong Y, Zhang N, Heffner K, Fox PT. A meta-analysis on neural changes of cognitive training for mental disorders in executive function tasks: increase or decrease brain activation? BMC Psychiatry 2022; 22:155. [PMID: 35232404 PMCID: PMC8886766 DOI: 10.1186/s12888-022-03796-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/10/2021] [Accepted: 02/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive impairment is often found in patients with psychiatric disorders, and cognitive training (CT) has been shown to help these patients. To better understand the mechanisms of CT, many neuroimaging studies have investigated the neural changes associated with it. However, the results of those studies have been inconsistent, making it difficult to draw conclusions from the literature. Therefore, the objective of this meta-analysis was to identify consistent patterns in the literature of neural changes associated with CT for psychiatric disorders. METHODS We searched for cognitive training imaging studies in PubMed, Cochrane library, Scopus, and ProQuest electronic databases. We conducted an activation likelihood estimation (ALE) for coordinate-based meta-analysis of neuroimaging studies, conduct behavioral analysis of brain regions identified by ALE analysis, conduct behavioral analysis of brain regions identified by ALE analysis, and then created a functional meta-analytic connectivity model (fMACM) of the resulting regions. RESULTS Results showed that CT studies consistently reported increased activation in the left inferior frontal gyrus (IFG) and decreased activation in the left precuneus and cuneus from pre- to post- CT. CONCLUSION CT improves cognitive function by supporting language and memory function, and reducing neuronal resources associated with basic visual processing.
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Affiliation(s)
- Jin Yang Li
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.89957.3a0000 0000 9255 8984Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Huiqin Wu
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Shiting Yuan
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Chun Wang
- Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029, Jiangsu, China. .,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Qian Wang
- grid.24696.3f0000 0004 0369 153XBeiJing TianTan Hospital, Capital Medical University, Beijing, 100050 China
| | - Yuan Zhong
- grid.260474.30000 0001 0089 5711School of Psychology, Nanjing Normal University, Nanjing, 210029 Jiangsu China
| | - Ning Zhang
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.89957.3a0000 0000 9255 8984Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029 Jiangsu China
| | - Kathi Heffner
- grid.412750.50000 0004 1936 9166Department of Psychiatry, University of Rochester School of Nursing, Rochester, New York 14622 USA
| | - Peter T. Fox
- grid.89957.3a0000 0000 9255 8984Nan jing Brain Hospital affiliated to Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.89957.3a0000 0000 9255 8984Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, 210029 Jiangsu China ,grid.267309.90000 0001 0629 5880South Texas Veterans Healthcare System, University of Texas Health San Antonio, San Antonio, USA ,grid.267309.90000 0001 0629 5880Research Imaging Institute, University of Texas Health San Antonio, San Antonio, USA
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