Decreased axial diffusivity within language connections: a possible biomarker of schizophrenia risk

Polygenic risk for schizophrenia and the language network: Putative compensatory reorganization in unaffected siblings

Language-related symptoms, such as disorganized, impoverished speech and communicative behaviors, are one of the core features of schizophrenia. These features most strongly correlate with cognitive deficits and polygenic risk among various symptom dimensions of schizophrenia. Nevertheless, unaffected siblings with genetic high-risk fail to show consistent deficits in language network (LN), indicating that either (1) polygenic risk has no notable effect on LN and/or (2) siblings show compensatory changes in opposing direction to patients. To answer this question, we related polygenic risk scores (PRS) to the region-level, tract-level, and systems-level structure (cortical thickness and fiber connectivity) of LN in 182 patients, 48 unaffected siblings and 135 healthy controls. We also studied the relationships between symptoms, language-related cognition, social functioning and LN structure. We observed a significantly lower thickness in LN (especially the Broca's, Wernicke's area and their right homologues) in patients. Siblings had a distinctly higher thickness in parts of the LN and a more pronounced small-world-like structural integration within the LN. Patients with reduced LN thickness had higher PRS, more disorganization and impoverished speech with lower language-related cognition and social functioning. We conclude that the genetic susceptibility and putative compensatory changes for schizophrenia operate, in part, via key regions in the Language Network.

Disembodiment and Language in Schizophrenia: An Integrated Psychopathological and Evolutionary Perspective

Different hypotheses have flourished to explain the evolutionary paradox of schizophrenia. In this contribution, we sought to illustrate how, in the schizophrenia spectrum, the concept of embodiment may underpin the phylogenetic and developmental pathways linking sensorimotor processes, the origin of human language, and the construction of a basic sense of the self. In particular, according to an embodied model of language, we suggest that the reuse of basic sensorimotor loops for language, while enabling the development of fully symbolic thought, has pushed the human brain close to the threshold of a severe disruption of self-embodiment processes, which are at the core of schizophrenia psychopathology. We adopted an inter-disciplinary approach (psychopathology, neuroscience, developmental biology) within an evolutionary framework, to gain an integrated, multi-perspectival model on the origin of schizophrenia vulnerability. A maladaptive over-expression of evolutionary-developmental trajectories toward language at the expense of embodiment processes would have led to the evolutionary "trade-off" of a hyper-symbolic activity to the detriment of a disembodied self. Therefore, schizophrenia psychopathology might be the cost of long-term co-evolutive interactions between brain and language.

The role of white matter abnormality in the left anterior corona radiata: In relation to formal thought disorder in patients with schizophrenia

White matter abnormality has been widely reported in patients with schizophrenia (Sz). However, few studies have focused on the relationship between the white matter deficit and formal thought disorder (FTD). Moreover, the role of genetic high risk in FTD-related white matter deficit remains unclear. The present study recruited 46 Sz patients, 18 unaffected first-degree relatives of Sz patients, and 29 healthy controls. There was a widespread fractional anisotropy (FA) reduction in Sz. In addition, reduced FA in the left anterior corona radiata was related to more severe FTD symptoms in Sz. However, the genetic high-risk group only showed lower mean FA in the left anterior limb of the internal capsule than healthy controls. Our findings suggest that abnormality in the left anterior corona radiata may only occur in Sz but not in the genetic high-risk group. Such an abnormality might be associated with the severity of FTD symptoms. Meanwhile, genetic vulnerability may contribute to the abnormality in the left anterior limb of the internal capsule. Better analytical methods are needed to validate our results.

Microstructural Abnormalities of the Dentatorubrothalamic Tract in Cervical Dystonia

BACKGROUND

The dentatorubrothalamic tract (DRTT) remains understudied in idiopathic cervical dystonia (CD), despite evidence that the pathway is relevant in the pathophysiology of the disorder.

OBJECTIVE

The aim of this study was to examine the DRTT in patients with CD using diffusion tensor imaging (DTI)-based tractography.

METHODS

Magnetic resonance imaging scans from 67 participants were collected to calculate diffusion tractography metrics using a binary tractography-based DRTT template. Fractional anisotropy and diffusivity measures of left and right DRTT were computed and compared between 32 subjects with CD and 35 age-matched healthy volunteers.

RESULTS

Fractional anisotropy of right DRTT and mean and axial diffusivity of left DRTT were significantly reduced in patients with CD. Similar abnormalities were observed in patients with focal CD and patients with CD without tremor. DTI metrics did not correlate with disease duration or severity.

CONCLUSIONS

Significant reductions in DTI measures suggest microstructural abnormalities within the DRTT in CD, characterized by a tractography pattern consistent with decreased axonal integrity. © 2021 International Parkinson and Movement Disorder Society.

The correlation between white matter integrity and pragmatic language processing in first episode schizophrenia

Objective: Higher-order language disturbances could be the result of white matter tract abnormalities. The study explores the relationship between white matter and pragmatic skills in first-episode schizophrenia. Methods: Thirty-four first-episode patients with schizophrenia and 32 healthy subjects participated in a pragmatic language and Diffusion Tensor Imaging study, where fractional anisotropy of the arcuate fasciculus, corpus callosum and cingulum was correlated with the Polish version of the Right Hemisphere Language Battery. Results: The patients showed reduced fractional anisotropy in the right arcuate fasciculus, left anterior cingulum bundle and left forceps minor. Among the first episode patients, reduced understanding of written metaphors correlated with reduced fractional anisotropy of left forceps minor, and greater explanation of written and picture metaphors correlated with reduced fractional anisotropy of the left anterior cingulum. Conclusions: The white matter dysfunctions may underlie the pragmatic language impairment in schizophrenia. Our results shed further light on the functional neuroanatomical basis of pragmatic language use by patients with schizophrenia.

Magnetic resonance diffusion tensor imaging in psychiatry: a narrative review of its potential role in diagnosis

Diffusion tensor imaging (DTI) is an imaging technique that uses magnetic resonance. It measures the diffusion of water molecules in tissues, which can occur either without restriction (i.e., in an isotropic manner) or limited by some obstacles, such as cell membranes (i.e., in an anisotropic manner). Diffusion is most often measured in terms of, inter alia, fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). DTI allows us to reconstruct, visualize, and evaluate certain qualities of white matter. To date, many studies have sought to associate various changes in the distribution of diffusion within the brain with mental diseases and disorders. A better understanding of white matter integrity disorders can help us recognize the causes of diseases, as well as help create objective methods of psychiatric diagnosis, identify biomarkers of mental illness, and improve pharmacotherapy. The aim of this work is to present the characteristics of DTI as well as current research on its use in schizophrenia, affective disorders, and other mental disorders.

Anatomical integrity within the inferior fronto-occipital fasciculus and semantic processing deficits in schizophrenia spectrum disorders

The core symptoms of schizophrenia spectrum disorders (SSD) include abnormal semantic processing which may rely on the ventral language stream of the human brain. Thus, structural disruption of the ventral language stream may play an important role in semantic deficits observed in SSD patients. Therefore, we compared white matter tract integrity in SSD patients and healthy controls using diffusion tensor imaging combined with probabilistic fiber tractography. For the ventral language stream, we assessed the inferior fronto-occipital fasciculus [IFOF], inferior longitudinal fasciculus, and uncinate fasciculus. The arcuate fasciculus and corticospinal tract were used as control tracts. In SSD patients, the relationship between semantic processing impairments and tract integrity was analyzed separately. Three-dimensional tract reconstructions were performed in 45/44 SSD patients/controls ("Bern sample") and replicated in an independent sample of 24/24 SSD patients/controls ("Basel sample"). Multivariate analyses of fractional anisotropy, mean, axial, and radial diffusivity of the left IFOF showed significant differences between SSD patients and controls (p_(FDR-corr) < 0.001, η_p² = 0.23) in the Bern sample. Axial diffusivity (AD) of the left UF was inversely correlated with semantic impairments (r = -0.454, p_(FDR-corr) = 0.035). In the Basel sample, significant group differences for the left IFOF were replicated (p < .01, η_p² = 0.29), while the correlation between AD of the left IFOF and semantic processing decline (r = -0.376, p = .09) showed a statistical trend. No significant effects were found for the dorsal language stream. This is direct evidence for the importance of the integrity of the ventral language stream, in particular the left IFOF, in semantic processing deficits in SSD.

Effects of unilateral cortical resection of the visual cortex on bilateral human white matter

Children with unilateral resections of ventral occipito-temporal cortex (VOTC) typically do not evince visual perceptual impairments, even when relatively large swathes of VOTC are resected. In search of possible explanations for this behavioral competence, we evaluated white matter microstructure and connectivity in eight pediatric epilepsy patients following unilateral cortical resection and 15 age-matched controls. To uncover both local and broader resection-induced effects, we analyzed tractography data using two complementary approaches. First, the microstructural properties were measured in the inferior longitudinal and the inferior fronto-occipital fasciculi, the major VOTC association tracts. Group differences were only evident in the ipsilesional, and not in the contralesional, hemisphere, and single-subject analyses revealed that these differences were limited to the site of the resection. Second, graph theory was used to characterize the connectivity of the contralesional occipito-temporal regions. There were no changes to the network properties in patients with left VOTC resections nor in patients with resections outside the VOTC, but altered network efficiency was observed in two cases with right VOTC resections. These results suggest that, in many, although perhaps not all, cases of unilateral VOTC resections in childhood, the white matter profile in the preserved contralesional hemisphere along with residual neural activity might be sufficient for normal visual perception.

Abnormal relationships between local and global brain measures in subjects at clinical high risk for psychosis: a pilot study

We examined whether abnormal volumes of several brain regions as well as their mutual associations that have been observed in patients with schizophrenia, are also present in individuals at clinical high-risk (CHR) for developing psychosis. 3T magnetic resonance imaging was acquired in 19 CHR and 20 age- and handedness-matched controls. Volumes were measured for the body and temporal horns of the lateral ventricles, hippocampus and amygdala as well as total brain, cortical gray matter, white matter, and subcortical gray matter volumes. Relationships between volumes as well as correlations between volumes and cognitive and clinical measures were explored. Ratios of lateral ventricular volume to total brain volume and temporal horn volume to total brain volume were calculated. Volumetric abnormalities were lateralized to the left hemisphere. Volumes of the left temporal horn, and marginally, of the body of the left lateral ventricle were larger, while left amygdala but not hippocampal volume was significantly smaller in CHR participants compared to controls. Total brain volume was also significantly smaller and the ratio of the temporal horn/total brain volume was significantly higher in CHR than in controls. White matter volume correlated positively with higher verbal fluency score while temporal horn volume correlated positively with a greater number of perseverative errors. Together with the finding of larger temporal horns and smaller amygdala volumes in the left hemisphere, these results indicate that the ratio of temporal horns volume to brain volume is abnormal in CHR compared to controls. These abnormalities present in CHR individuals may constitute the biological basis for at least some of the CHR syndrome.

Deficits in Cortical Suppression During Vocalization are Associated With Structural Abnormalities in the Arcuate Fasciculus in Early Illness Schizophrenia and Clinical High Risk for Psychosis

Self-generated speech produces a smaller N1 amplitude in the auditory-evoked potential than externally generated speech; this phenomenon is known as N1-suppression. Schizophrenia patients show less N1-suppression than healthy controls. This failure to self-suppress may underlie patients' characteristic tendency to misattribute self-generated thoughts and actions to external sources. While the cause of N1-suppression deficits to speech in schizophrenia remains unclear, structural damage to the arcuate fasciculus is a candidate, due to its ostensible role in transmitting the efference copy of the motor plan to speak. Fifty-one patients with early illness schizophrenia (ESZ), 40 individuals at clinical high-risk for psychosis (CHR), and 59 healthy control (HC) participants underwent an electroencephalogram while they spoke and then listened to a recording of their speech. N1-suppression to the spoken sounds was calculated. Participants also underwent a diffusion-tensor imaging (DTI) scan, from which the arcuate fasciculus and pyramidal tract were extracted with deterministic tractography. ESZ patients exhibited significantly less N1-suppression to self-generated speech than HC participants, with CHR participants exhibiting intermediate levels. ESZ patients also exhibited structural abnormalities in the arcuate fasciculus-specifically, reduced fractional anisotropy and increased radial diffusivity-relative to both HC and CHR. There were no between-group differences in the structural integrity of the pyramidal tract. Finally, level of N1-suppression was linearly related to the structural integrity of the arcuate fasciculus, but not the pyramidal tract, across groups. These results suggest that the self-suppression deficits to willed speech consistently observed in schizophrenia patients may be caused, at least in part, by structural damage to the arcuate fasciculus.

Decreased integrity of the fronto-temporal fibers of the left inferior occipito-frontal fasciculus associated with auditory verbal hallucinations in schizophrenia

Auditory verbal hallucinations (AVH) have been proposed to result from altered connectivity between frontal speech production regions and temporal speech perception regions. Whilst the dorsal language pathway, serviced by the arcuate fasciculus, has been extensively studied in relation to AVH, the ventral language pathway, serviced by the inferior occipito-frontal fasciculus (IOFF) has been rarely studied in relation to AVH. This study examined whether structural changes in anatomically defined subregions of the IOFF were associated with AVH in patients with schizophrenia. Diffusion tensor imaging scans and clinical data were obtained from the Australian Schizophrenia Research Bank for 113 schizophrenia patients, of whom 39 had lifetime experience of AVH (18 had current AVH, 21 had remitted AVH), 74 had no lifetime experience of AVH, and 40 healthy controls. Schizophrenia patients with a lifetime experience of AVH exhibited reduced fractional anisotropy (FA) in the fronto-temporal fibers of the left IOFF compared to both healthy controls and schizophrenia patients without AVH. In contrast, structural abnormalities in the temporal and occipital regions of the IOFF were observed bilaterally in both patient groups, relative to the healthy controls. These results suggest that while changes in the structural integrity of the bilateral IOFF are associated with schizophrenia per se, integrity reductions in the fronto-temporal fibers of the left IOFF may be specifically associated with AVH.

Fornix Structural Connectivity and Allostatic Load: Empirical Evidence From Schizophrenia Patients and Healthy Controls

OBJECTIVE

The fornix is a white matter tract carrying the fibers connecting the hippocampus and the hypothalamus, two essential stress-regulatory structures of the brain. We tested the hypothesis that allostatic load (AL), derived from a battery of peripheral biomarkers indexing the cumulative effects of stress, is associated with abnormalities in brain white matter microstructure, especially the fornix, and that higher AL may help explain the white matter abnormalities in schizophrenia.

METHODS

Using 13 predefined biomarkers, we tested AL in 44 schizophrenic patients and 33 healthy controls. Diffusion tensor imaging was used to obtain fractional anisotropy (FA) values of the fornix and other white matter tracts.

RESULTS

AL scores were significantly elevated in patients compared with controls (F(3,77) = 7.87, p = .006). AL was significantly and inversely correlated with FA of fornix in both controls (r = -.58, p = .001) and patients (r = -.36, p = .023). Several nominally significant (p < .05 but did not survive Bonferroni correction for multiple comparison) correlations were also observed between AL and FA of other white matter tracts in schizophrenic patients. However, the fornix was the only tract exhibiting a correlation with AL in both groups.

CONCLUSIONS

These results provide initial evidence that allostatic processes are linked to fornix microstructure in clinical participants.

Abnormal Rich-Club Organization Associated with Compromised Cognitive Function in Patients with Schizophrenia and Their Unaffected Parents

Schizophrenia is considered to be a disorder of brain connectivity, which might result from a disproportionally impaired rich-club organization. The rich-club is composed of highly interconnected hub regions that play crucial roles in integrating information between different brain regions. Few studies have yet investigated whether the structural rich-club organization is impaired in patients and their first-degree relatives. In this study, we established a weighted network model of white matter connections using diffusion tensor imaging of 19 patients and 39 unaffected parents, 22 young healthy controls for the patients, and 25 old healthy controls for the parents. Feeder edges between rich-club nodes and non-rich-club nodes were significantly decreased in both schizophrenic patients and their unaffected parents compared with controls. Furthermore, the feeder edges showed significant positive correlations with the scores in Category Fluency Test-animal naming in the unaffected parents. Specific feeder edges exhibited discriminative power with accuracy of 84.4% in distinguishing unaffected parents from old healthy controls. Our findings suggest that impaired rich-club organization, especially impaired feeder edges, may be related to familial vulnerability to schizophrenia, possibly reflecting a genetic predisposition for schizophrenia.

Reduced fronto-striatal white matter integrity in schizophrenia patients and unaffected siblings: a DTI study

Background:

Schizophrenia is characterized by impairments in the fronto–striatal network. Underlying these impairments may be disruptions in anatomical pathways connecting frontal and striatal regions. However, the specifics of these disruptions remain unclear and whether these impairments are related to the genetic vulnerability of schizophrenia is not known.

Methods:

Here, we investigated fronto–striatal tract connections in 24 schizophrenia patients, 30 unaffected siblings, and 58 healthy controls using diffusion tensor imaging. Mean fractional anisotropy (FA) was calculated for tracts connecting the striatum with frontal cortex regions including the dorsolateral prefrontal cortex (DLPFC), medial orbital frontal cortex, and inferior frontal gyrus. Specifically, the striatum was divided into three subregions (caudate nucleus, putamen, and nucleus accumbens) and mean FA was computed for tracts originating from these striatal subregions.

Results:

We found no differences between patients, siblings, and controls in mean FA when taking the whole striatum as a seed region. However, subregion analyses showed reduced FA in the tract connecting the left nucleus accumbens and left DLPFC in both patients (P=0.0003) and siblings (P=0.0008) compared with controls.

Conclusions:

The result of reduced FA in the tract connecting the left nucleus accumbens and left DLPFC indicates a possible reduction of white matter integrity, commonly associated with schizophrenia. As both patients and unaffected siblings show reduced FA, this may represent a vulnerability factor for schizophrenia.

Alterations in frontal white matter neurochemistry and microstructure in schizophrenia: implications for neuroinflammation

We investigated in vivo neurochemical markers reflective of neuronal health and glial activation to determine if these could yield clues regarding the reduced fractional anisotropy (FA) of white matter and accelerated decline of FA with age in schizophrenia. Participants with schizophrenia and healthy controls completed diffusion tensor imaging to assess FA and proton magnetic resonance spectroscopy to assess neurochemical metabolites in the same frontal region. Frontal FA was significantly lower in the schizophrenia and declined more rapidly with age compared with the healthy control group. In both groups, N-acetylaspartate (NAA), a putative marker of neuronal integrity, and glutamate declined with age, and this decline was stronger in patients. Myo-inositol, a marker of glial cells, was negatively related to FA in both groups. The relationship between FA and age remained significant in schizophrenia even when controlling for all metabolites. The relationships of FA, NAA and myo-inositol to age appear to be independent of one another. The relationship between FA and myo-inositol was independently present in both patients and controls, even after controlling for age, indicating a potential general effect of neuroinflammation on white matter microstructure. Further studies are warranted to determine the underlying mechanism driving the accelerated FA decline with age in schizophrenia.

Prefrontal cortex and the dysconnectivity hypothesis of schizophrenia

Schizophrenia is hypothesized to arise from disrupted brain connectivity. This "dysconnectivity hypothesis" has generated interest in discovering whether there is anatomical and functional dysconnectivity between the prefrontal cortex (PFC) and other brain regions, and how this dysconnectivity is linked to the impaired cognitive functions and aberrant behaviors of schizophrenia. Critical advances in neuroimaging technologies, including diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), make it possible to explore these issues. DTI affords the possibility to explore anatomical connectivity in the human brain in vivo and fMRI can be used to make inferences about functional connections between brain regions. In this review, we present major advances in the understanding of PFC anatomical and functional dysconnectivity and their implications in schizophrenia. We then briefly discuss future prospects that need to be explored in order to move beyond simple mapping of connectivity changes to elucidate the neuronal mechanisms underlying schizophrenia.

White matter changes in first episode psychosis and their relation to the size of sample studied: a DTI study

BACKGROUND

White matter abnormality has been recently proposed as a pathophysiological feature of schizophrenia (SZ). However, most of the data available has been gathered from chronic patients, and was therefore possibly confounded by factors such as duration of the disease, and treatment received. The extent and localization of these changes is also not clear.

METHODS

We examined a population of early stage SZ patients using diffusion tensor imaging (DTI). 77 SZ patients and 60 healthy controls (HCs) were included in the analysis using Tract-Based Spatial Statistics (TBSS). We have also analyzed 250 randomly created subsets of the original cohort, to investigate the relation between the result of TBSS analysis, and the size of the sample studied.

RESULTS

We have found a significant decrease in fractional anisotropy (FA) in the patient group. This change is present in most major white matter (WM) tracts including the corpus callosum, superior and inferior longitudinal fasciculi, inferior fronto-occipital fasciculus, and posterior thalamic radiation. Furthermore, we identified a clear trend towards an increase in the number and spatial extent of significant voxels reported, with an increasing number of subjects included in the analysis.

CONCLUSION

Our study shows that FA is significantly decreased in patients at an early stage of schizophrenia, and that the extent of this finding is dependent on the size of studied sample; therefore underpowered studies might produce results with false spatial localization.

Fractional anisotropy in individuals with schizophrenia and their nonpsychotic siblings

Fractional anisotropy (FA) was examined in a priori selected fiber tracts in individuals with schizophrenia (n=25) and their non-psychotic siblings (n=29) versus controls (n=35). FA was reduced in a portion of the fornix in individuals with schizophrenia (although this did not survive correction for the number of tracts investigated). FA in the siblings did not differ from that in controls in any of the investigated tracts.

White matter microstructural abnormalities of the cingulum bundle in youths with 22q11.2 deletion syndrome: associations with medication, neuropsychological function, and prodromal symptoms of psychosis

BACKGROUND

The 22q11.2 deletion syndrome (22q11.2DS) is regarded as an etiologically homogenous model for understanding neuroanatomic disruptions associated with a high risk for schizophrenia. This study utilized diffusion tensor imaging (DTI) to analyze white matter microstructure in individuals with 22q11.2DS. We focused on the cingulum bundle (CB), previously shown to be disrupted in patients with schizophrenia and associated with symptoms of psychosis.

METHODS

White matter microstructure was assessed in the anterior, superior, and posterior CB using the tractography algorithm in DTIStudio. Neuropsychological function, presence of prodromal symptoms of psychosis, and medication history were assessed in all participants.

RESULTS

Relative to controls, young adults with 22q11.2DS showed alterations in most DTI metrics of the CB. Alterations were associated with positive prodromal symptoms of psychosis. However, when individuals with 22q11.2DS were divided by usage of antipsychotics/mood stabilizers, the medicated and non-medicated groups differed significantly in axial diffusivity of the anterior CB and in fractional anisotropy of the superior CB. DTI metrics did not differ between the medicated group and the control group.

CONCLUSIONS

Results suggest that the microstructure of the CB is altered in individuals with 22q11.2DS, and that those alterations may underlie positive prodromal symptoms of psychosis. Our findings further provide preliminary evidence that antipsychotic/mood stabilizer usage may have a reparative effect on white matter microstructure in prodromal 22q11.2DS, independent of the potential effects of psychosis. Future studies of white matter pathology in individuals with 22q11.2DS should test for potential effects of medication on white matter microstructure.

Altered integrity of the right arcuate fasciculus as a trait marker of schizophrenia: a sibling study using tractography-based analysis of the whole brain

Trait markers of schizophrenia aid the dissection of the heterogeneous phenotypes into distinct subtypes and facilitate the genetic underpinning of the disease. The microstructural integrity of the white matter tracts could serve as a trait marker of schizophrenia, and tractography-based analysis (TBA) is the current method of choice. Manual tractography is time-consuming and limits the analysis to preselected fiber tracts. Here, we sought to identify a trait marker of schizophrenia from among 74 fiber tracts across the whole brain using a novel automatic TBA method. Thirty-one patients with schizophrenia, 31 unaffected siblings and 31 healthy controls were recruited to undergo diffusion spectrum magnetic resonance imaging at 3T. Generalized fractional anisotropy (GFA), an index reflecting tract integrity, was computed for each tract and compared among the three groups. Ten tracts were found to exhibit significant differences between the groups with a linear, stepwise order from controls to siblings to patients; they included the right arcuate fasciculus, bilateral fornices, bilateral auditory tracts, left optic radiation, the genu of the corpus callosum, and the corpus callosum to the bilateral dorsolateral prefrontal cortices, bilateral temporal poles, and bilateral hippocampi. Posthoc between-group analyses revealed that the GFA of the right arcuate fasciculus was significantly decreased in both the patients and unaffected siblings compared to the controls. Furthermore, the GFA of the right arcuate fasciculus exhibited a trend toward positive symptom scores. In conclusion, the right arcuate fasciculus may be a candidate trait marker and deserves further study to verify any genetic association.

Left fronto-temporal dysconnectivity within the language network in schizophrenia: an fMRI and DTI study

Schizophrenia is a mental disorder characterized by language disorders. Studies reveal that both a functional dysconnectivity and a disturbance in the integrity of white matter fibers are implicated in the language process in patients with schizophrenia. Here, we investigate the relationship between functional connectivity within a language-comprehension network and anatomical connectivity using fiber tracking in schizophrenia. We hypothesized that patients would present an impaired functional connectivity in the language network due to anatomical dysconnectivity. Participants comprised 20 patients with DSM-IV schizophrenia and 20 healthy controls who were studied with functional magnetic resonance imaging and diffusion tensor imaging. The temporal correlation coefficient and diffusion values between the left frontal and temporal clusters, belonging to the language network, were individually extracted, in order to study the relationships of anatomo-functional connectivity. In patients, functional connectivity was positively correlated with fractional anisotropy, but was negatively correlated with radial diffusivity and/or mean diffusivity, in the left arcuate fasciculus and part of the inferior occipitofrontal fasciculus, determined as the fronto-temporal tracts. Our findings indicate a close relationship between functional and anatomical dysconnectivity in patients with schizophrenia. The disturbance in the integrity of the left fronto-temporal tracts might be one origin of the functional dysconnectivity in the language-comprehension network in schizophrenia.

Diffusion Tensor Imaging findings and their implications in schizophrenia

PURPOSE OF REVIEW

Schizophrenia is a multifocal brain disease that involves abnormal brain connectivity. Diffusion Tensor Imaging is the most advanced imaging technique to investigate white matter connections in vivo. In this review, we focus on studies published in the last year with a high impact on our understanding of how changes in white matter may lead to better treatment.

RECENT FINDINGS

Recent studies establish white matter changes at illness onset, and quite possibly before, wherein they constitute a risk factor. Some studies also suggest that white matter changes might not progress over time, even without treatment. Further, while genetic risk may be associated with neurodevelopmental changes related to either white matter geometry, or a different trajectory of aging, clinical risk may also be associated with more acute changes of tissue integrity. These latter changes may be inflammatory in nature at illness onset, and related to the cellular integrity of oligodendrocytes and/or astrocytes at later stages of illness.

SUMMARY

Recent publications suggest new directions for research and lead to new hypotheses about the pathophysiology of schizophrenia involving white matter. When replicated on larger samples, this knowledge will likely lead to the development of new treatment strategies.

Brain structure in different psychosis risk groups in the Northern Finland 1986 birth cohort

We tested the hypothesis that family risk for psychosis (FR) and clinical risk for psychosis (CR) are associated with structural brain abnormalities, with increased deficits in those at both family risk and clinical risk for psychosis (FRCR). The study setting was the Oulu Brain and Mind Study, with subjects drawn from the Northern Finland 1986 Birth Cohort (n=9479) using register and questionnaire based screening, and interviews using the Structured Interview for Prodromal Symptoms. After this procedure, 172 subjects were included in the study, classified as controls (n=73) and three risk groups: FR excluding CR (FR, n=60), CR without FR (CR, n=26), and individuals at both FR and CR (FRCR, n=13). T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. In the comparison between FRCR versus controls, we found lower grey matter volume (GMV) in a cluster (1689 voxels at -4.00, -72.00, -18.00mm) covering both cerebellar hemispheres and the vermis. This cluster was subsequently used as a mask to extract mean GMV in all four groups: FR had a volume intermediate between controls and FRCR. Within FRCR there was an association between cerebellar cluster brain volume and motor function. These findings are consistent with an evolving pattern of cerebellar deficits in psychosis risk with the most pronounced deficits in those at highest risk of psychosis.

Brain networks in schizophrenia. Neuropsychol Rev. 2014;24:32-48. [PMID: 24500505 DOI: 10.1007/s11065-014-9248-7]

Schizophrenia--a severe psychiatric condition characterized by hallucinations, delusions, loss of initiative and cognitive function--is hypothesized to result from abnormal anatomical neural connectivity and a consequent decoupling of the brain's integrative thought processes. The rise of in vivo neuroimaging techniques has refueled the formulation of dysconnectivity hypotheses, linking schizophrenia to abnormal structural and functional connectivity in the brain at both microscopic and macroscopic levels. Over the past few years, advances in high-field structural and functional neuroimaging techniques have made it increasingly feasible to reconstruct comprehensive maps of the macroscopic neural wiring system of the human brain, know as the connectome. In parallel, advances in network science and graph theory have improved our ability to study the spatial and topological organizational layout of such neural connectivity maps in detail. Combined, the field of neural connectomics has created a novel platform that provides a deeper understanding of the overall organization of brain wiring, its relation to healthy brain function and human cognition, and conversely, how brain disorders such as schizophrenia arise from abnormal brain network wiring and dynamics. In this review we discuss recent findings of connectomic studies in schizophrenia that examine how the disorder relates to disruptions of brain connectivity.