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Korann V, Thonse U, Garani R, Jacob A, Ramkiran S, Praharaj SK, Bharath RD, Kumar V, Varambally S, Venkatasubramanian G, Rao NP. Association between urban upbringing and functional brain connectivity in schizophrenia. Indian J Psychiatry 2024; 66:71-81. [PMID: 38419936 PMCID: PMC10898520 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_560_23] [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: 07/27/2023] [Revised: 11/26/2023] [Accepted: 12/25/2023] [Indexed: 03/02/2024] Open
Abstract
Background Environmental factors considerably influence the development of the human cortex during the perinatal period, early childhood, and adolescence. Urban upbringing in the first 15 years of life is a known risk factor for schizophrenia (SCZ). Though the risk of urban birth and upbringing is well-examined from an epidemiological perspective, the biological mechanisms underlying urban upbringing remain unknown. The effect of urban birth and upbringing on functional brain connectivity in SCZ patients is not yet examined. Methods This is a secondary data analysis of three studies that included 87 patients with SCZ and 70 healthy volunteers (HV) aged 18 to 50 years. We calculated the developmental urbanicity index using a validated method in earlier studies. Following standard pre-processing of resting functional magnetic resonance imaging (fMRI) scans, seed-return on investment (ROI) functional connectivity analysis was performed. Results The results showed a significant association between urban birth and upbringing on functional connectivity in SCZ patients and HV (P < 0.05). In SCZ patients, connections from the right caudate, anterior cingulate cortex, left and right intracalcarine cortices, left and right lingual gyri, left posterior parahippocampal cortex to the cerebellum, fusiform gyri, lateral occipital cortex, and amygdala were significantly associated with the urbanicity index (P < 0.05). Conclusions These study findings suggest a significant association between urban birth and upbringing on functional brain connectivity in regions involved in reward processing and social cognition in SCZ. Assessment of social cognition could have implications in developing an in-depth understanding of this impairment in persons with SCZ.
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Affiliation(s)
- Vittal Korann
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Umesh Thonse
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ranjini Garani
- Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shukti Ramkiran
- Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Samir K. Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rose D. Bharath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Naren P. Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Simha A, Prasad R, Ahmed S, Dinesh AS, Rao NP. Effect of national cultural dimensions and HIV prevalence rates on stigma towards people living with HIV/AIDS. PSYCHOL HEALTH MED 2023; 28:2908-2914. [PMID: 35361006 DOI: 10.1080/13548506.2022.2057557] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
This paper examines the main and interactive effects of national culture dimensions and HIV prevalence rates on stigma towards people living with HIV/AIDS (PLHIVA). We examined these various relationships using data from a sample of 68,041 individuals from 49 countries, obtained from the World Values Survey. We used Hierarchical Linear Modeling to conduct our cross-level analyses. Our results indicated that collectivistic societies were positively associated while egalitarian and performance-oriented societies were negatively associated with stigma towards PLHIVA. Additionally, HIV prevalence rates interact with several cultural dimensions to worsen stigma towards PLHIVA. Our findings indicate the need to tailor stigma reduction strategies by taking the national culture dimensions of a given society into consideration when designing and implementing programs.
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Affiliation(s)
- Aditya Simha
- Department of Management, University of Wisconsin, Whitewater, WI, USA
| | - Ramakrishna Prasad
- PCMH Restore Health; National Center for Primary Care Research & Policy, Academy of Family Physicians of India (AFPI), Bengaluru, India
| | - Sana Ahmed
- Department of Management, Independent Scholar, United States of America
| | | | - Naren P Rao
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, India
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3
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Prasannakumar A, Kumar V, Mailankody P, Appaji A, Battu R, Berendschot TTJM, Rao NP. A systematic review and meta-analysis of optical coherence tomography studies in schizophrenia, bipolar disorder and major depressive disorder. World J Biol Psychiatry 2023; 24:707-720. [PMID: 37070475 DOI: 10.1080/15622975.2023.2203231] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVES Due to the common neurodevelopmental origin and easy accessibility, the retina serves as a surrogate marker for changes in the brain. Hence, Optical Coherence Tomography (OCT), a tool to examine the neuronal layers of retina has gained importance in investigating psychiatric disorders. Several studies in the last decade have reported retinal structural alterations in schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). However, the findings are inconsistent. Hence, we conducted a meta-analysis to investigate alterations in OCT parameters in patients with SCZ, BD and MDD. METHODS We searched electronic databases for studies that examined OCT parameters in patients with SCZ, BD and MDD published up to January 2023. The primary outcome measures were thickness and volumes of the retinal Nerve Fibre Layer (RNFL). We conducted meta-analysis using a random effects model. RESULTS The searches yielded 2638 publications of which 43 studies were included in the final analysis across all disorders. Compared to controls, the RNFL was thinner in SCZ patients (SMD = -0.37, p = <0.001) and BD patients (SMD = -0.67, p = < 0.001), but not in MDD patients (SMD = -0.08, p = 0.54). On quadrant wise analysis, temporal quadrant RNFL was thinner in SCZ but not in BD, while all other quadrants were thinner in both SCZ and BD. CONCLUSION We found significant reductions in RNFL thickness in SCZ and BD, but not in MDD. The differential involvement in various quadrants and parameters across the disorders has potential implications for using retinal parameters as a diagnostic biomarker.
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Affiliation(s)
- Akash Prasannakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Pooja Mailankody
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Abhishek Appaji
- Department of Medical Electronics, BMS College of Engineering, Bangalore, Karnataka, India
- Department of Opthalmology, University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Rajani Battu
- Department of Opthalmology, Centre for Eye Genetics and Research, Bangalore, Karnataka, India
| | - Tos T J M Berendschot
- Department of Opthalmology, University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Prasannakumar A, Kumar V, Rao NP. Trust and psychosis: a systematic review and meta-analysis. Psychol Med 2023; 53:5218-5226. [PMID: 35975354 DOI: 10.1017/s0033291722002562] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Impaired trust in other humans is commonly seen in psychosis and it leads to poor societal functioning. However, examining trust behavior in an experimental setting is challenging. Investigators have used the trust game, a neuro-economic game to assess trust behavior in psychosis. However, the findings are inconsistent. Hence, we systematically reviewed the existing literature and conducted a meta-analysis to examine trust behavior in patients with psychosis, their relatives, and those at high risk for psychosis. METHODS We searched electronic databases for studies that have examined trust game in patients with psychosis, published up to November 2021. The primary outcome measure was the baseline trust in a trust game by patients and controls. The meta-analysis was performed if at least three data sets of control and patient groups were available for that measure/design. We conducted meta-analyses with a random-effects model. The results were described narratively wherever meta-analysis was not possible due to paucity of studies. RESULTS The searches across the databases including cross-references yielded 465 publications of which 10 studies were included in the final analysis. Baseline trust in the trust game was significantly lower in patients with psychosis compared to controls (SMD 0.39, 95% CI -0.14 to 0.64, p -0.002). However, a similar decrease in baseline trust was not present in relatives of patients (SMD 0.08, 95% CI -0.20 to 0.36, p -0.58). CONCLUSIONS The current meta-analysis suggests significant trust deficits in patients with psychosis. Future studies with a bigger sample size are required to understand the nature of trust deficits and factors affecting this impairment.
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Affiliation(s)
- Akash Prasannakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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Suhas S, Malo PK, Kumar V, Issac TG, Chithra NK, Bhaskarapillai B, Reddy YCJ, Rao NP. Treatment strategies for serotonin reuptake inhibitor-resistant obsessive-compulsive disorder: A network meta-analysis of randomised controlled trials. World J Biol Psychiatry 2023; 24:162-177. [PMID: 35615998 DOI: 10.1080/15622975.2022.2082525] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Treatment-resistant obsessive-compulsive disorder is a chronic debilitating illness. We conducted a network meta-analysis [NMA] to compare the efficacy of all interventions in SRI-resistant OCD from published Randomised controlled trials [RCT]. METHODS We performed an NMA of RCTs in SRI resistant OCD from all modalities of treatments; pharmacological, psychological, neuromodulation, neurosurgery including deep brain stimulation. The design-by-treatment interaction inconsistency model within the frequentist framework was adopted with a change in Yale-Brown Obsessive-Compulsive Scale score as the primary outcome. We conducted sensitivity analyses excluding studies examining neurosurgical interventions, deep brain stimulation, studies in the paediatric population, and studies from a single geographical region. We also conducted analyses of interventions categorised into treatment groups. RESULTS 55 RCTs examining 19 treatments or placebo involving 2011 participants were included in the NMA. Ondansetron [Standardised mean difference -2.01 (95% CI: -3.19, -0.83)], deep TMS [- 1.95 (-3.25, -0.65)], therapist administered Cognitive Behavioural Therapy [CBT-TA] [-1.46 (-2.93, 0.01)] and aripiprazole [-1.36 (-2.56, -0.17)] were ranked as the best four treatments on using the Surface Under the Cumulative Ranking [SUCRA] percentage values (85.4%, 83.2%, 80.3%, 67.9% respectively). While all four interventions had large effect sizes, CBT[TA] narrowly missed statistical significance in our analysis. In sensitivity analyses, deep TMS was ranked as the best treatment strategy for SRI-resistant OCD. The small number of subjects in individual studies, higher confidence interval limits, and wider prediction interval for most agents warrant a cautious interpretation. CONCLUSIONS Considering the principal analysis and sensitivity analyses together, deep TMS, ondansetron, CBT[TA], and aripiprazole may be considered a first-line intervention for SRI-resistant OCD in adults. OTHER This work was not funded. The NMA has been registered with PROSPERO, [Registration number: CRD42020173589].
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Affiliation(s)
- Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
| | - Palash Kumar Malo
- Department of Biostatistics, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
| | - Thomas Gregor Issac
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
| | - Nellai K Chithra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
| | - Binukumar Bhaskarapillai
- Department of Biostatistics, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
| | - Y C Janardhan Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bangalore, India
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Bhargav H, Eiman N, Jasti N, More P, Kumar V, Holla B, Arasappa R, Rao NP, Varambally S, Gangadhar B, Keshavan MS. Composition of yoga-philosophy based mental traits ( Gunas) in major psychiatric disorders: A trans-diagnostic approach. Front Psychol 2023; 14:1075060. [PMID: 36818072 PMCID: PMC9930472 DOI: 10.3389/fpsyg.2023.1075060] [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: 10/20/2022] [Accepted: 01/04/2023] [Indexed: 02/04/2023] Open
Abstract
Yoga philosophy includes the theory of Tri-guna (three mental traits): sattva (signifies a tendency to 'goodness'), rajas (tendency towards 'activity'), and tamas (tendency towards "inertia"). This cross-sectional study aimed to understand the differences in the expression of gunas in patients suffering from major psychiatric disorders (n = 113, 40 females) and age-gender-education-matched healthy controls (HCs; n = 113, 40 females). Patients were diagnosed by a psychiatrist using DSM 5 criteria and suffered from the following disorders: depression (n = 30), schizophrenia (SCZ; n = 28), obsessive-compulsive disorder (OCD; n = 23), anxiety (n = 16), and bipolar affective disorder (BPAD; n = 16). Tri-gunas were assessed using a validated tool (Vedic Personality Inventory) and symptoms were assessed using standard scales as per the diagnosis. Multi-variate analysis of variance (MANOVA) was used to assess the differences in guna scores between HCs and patients, and between patients with different diagnoses. A two-tailed Pearson correlation was performed between the gunas and psychometric scales. Results revealed that HCs had significantly higher sattva traits as compared to patients (except those with OCD). Each psychiatric diagnosis also showed a specific guna configuration: (1) Anxiety disorders and OCD: High sattva-rajas, low tamas; (2) Depression: High sattva-tamas, low rajas; (3) Psychotic disorders (SCZ/BPAD): High tamo-rajas, low sattva. Significant positive correlations were observed between rajas traits and anxiety/OC/positive psychotic symptoms, negative psychotic symptoms and tamas traits, and sattva traits and OC symptoms. This finding has clinical implications, both to develop ways of predicting outcomes of psychiatric disorders, as well as to develop psycho-therapeutic and lifestyle interventions targeting the gunas.
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Affiliation(s)
- Hemant Bhargav
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India,*Correspondence: Hemant Bhargav, ✉
| | - Najla Eiman
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Nishitha Jasti
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pooja More
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vinod Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Bharath Holla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rashmi Arasappa
- Massachusetts Mental Health Center, Boston, MA, United States
| | - Naren P. Rao
- Massachusetts Mental Health Center, Boston, MA, United States
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - B.N. Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Matcheri S. Keshavan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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Suhas S, Chougule A, Innamuri R, Nayok SB, Sheth S, Nagendrappa S, Patel KG, Shetty SB, Nagendra B, Bhaumik U, Pugalenthi S, Uppal G, Babu GN, Rao NP, Behere RV. Training Initiative for Psychiatry Post-graduate students (TIPPS)-a Unique Early Career Psychiatry Training Initiative in India and Its Response to the COVID-19 Pandemic. Acad Psychiatry 2022; 46:763-768. [PMID: 35028931 PMCID: PMC8758236 DOI: 10.1007/s40596-021-01570-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Satish Suhas
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | | | - Sweta Sheth
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Krishna G Patel
- C. U. Shah Medical College and Hospital, Surendranagar, Gujarat, India
| | | | | | | | | | | | - Girish N Babu
- Department of Psychiatry, SDM Medical College, Dharwad, India.
| | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India
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8
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Simha A, Ahmed S, Prasad R, Dinesh AS, Kandasamy A, Rao NP. Effect of national cultural dimensions and consumption rates on stigma toward alcohol and substance use disorders. Int J Soc Psychiatry 2022; 68:1411-1417. [PMID: 34213385 DOI: 10.1177/00207640211028611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/17/2022]
Abstract
BACKGROUND Despite the notion of stigma as a socio-cultural process with the concept rooted in social space rather than in individual space, global studies examining impact of cultural differences on stigma toward substance use disorders are lacking. AIM In this study, we aim to study the influence of national culture differences on stigma toward alcohol and substance use disorders. METHODS We analyzed individual-level data from 68,041 respondents from 49 countries on stigma toward alcohol and substance use disorders. We examined the effect of the national culture dimensions and national alcohol and substance consumption rates on stigma toward alcohol and substance use disorders using hierarchical linear modeling. RESULTS Our hierarchical linear modeling results indicate that cultural dimensions and consumption rates significantly influence stigma. We found significant positive associations between stigma toward AUD and institutional collectivism and assertiveness, but a negative association with future orientation dimension. Like AUD, stigma toward SUD was also positively associated with institutional collectivism and assertiveness, but negatively associated with power distance. CONCLUSIONS The study findings have immense implications for national interventions to decrease stigma and influence policy making.
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Affiliation(s)
| | | | - Ramakrishna Prasad
- PCMH Restore Health, National Center for Primary Care Research and Policy, Academy of Family Physicians of India, Bengaluru, Karnataka, India
| | - Akshay S Dinesh
- PCMH Restore Health, Metastring Foundation, Bengaluru, Karnataka, India
| | - Arun Kandasamy
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Selvaraj S, Shivakumar V, Kavya PV, Mullapudi T, Bhalerao G, Sreeraj VS, Suhas S, Dinakaran D, Parlikar R, Chhabra H, Narayanaswamy JC, Debnath M, Rao NP, Muralidharan K, Venkatasubramanian G. Neurohemodynamic correlates of BDNF gene expression in schizophrenia patients with working memory deficits: A functional MRI study. Asian J Psychiatr 2022; 77:103261. [PMID: 36181754 DOI: 10.1016/j.ajp.2022.103261] [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: 05/13/2022] [Revised: 08/18/2022] [Accepted: 09/14/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Brain-derived neurotrophic factor (BDNF) is involved in neuroplasticity underlying cognitive deficits, including working memory deficits (WMD), in schizophrenia. Methodological challenges and inconsistencies are reported with peripheral BDNF levels. Left dorsolateral prefrontal cortex (DLPFC) is proposed to underlie WMD, though inconsistently. We aimed to explore the correlations between brain activation during working memory task-based functional Magnetic Resonance Imaging (fMRI) and BDNF gene expression in schizophrenia patients with WMD. METHODS 26 patients with schizophrenia with established WMD were recruited for the study. Blood samples were collected to study lymphocyte BDNF gene expression. Patients underwent task-based fMRI to examine the working memory performance and related brain activation. Whole-brain analysis was performed with 2-back > 0-back and 2-back > rest contrast. The peak intensity values of the activation were used for correlation analysis. RESULTS Whole brain analysis with 2-back > rest contrast revealed maximum activation in left DLPFC, Brodmann area 9 (t = 10.54, FWE corrected p < 0.05). The baseline BDNF gene expression correlated positively with the peak intensity of brain activation in left DLPFC (r = 0.365, p = 0.033). Negative symptom score negatively correlated with BDNF gene expression (r = -0.499, p = 0.005) and left DLPFC fMRI activation (r = -0.393, p = 0.023) respectively. CONCLUSION We found a significant positive association between BDNF gene expression and the activation of the DLPFC during the working memory task. This novel observation needs further systematic evaluation to establish the potential role of peripheral BDNF expression in WMD in schizophrenia.
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Affiliation(s)
- Sowmya Selvaraj
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India.
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Paranthaman V Kavya
- Department of Human Genetics, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Thrinath Mullapudi
- Department of Human Genetics, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Gaurav Bhalerao
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Vanteemar S Sreeraj
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Satish Suhas
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Damodharan Dinakaran
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Rujuta Parlikar
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Harleen Chhabra
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
| | | | - Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
| | - Kesavan Muralidharan
- Department of Psychiatry, National Institute of Mental Health And Neurosciences, Bangalore, India
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Sukumaran SK, Paul P, Guttal V, Holla B, Vemula A, Bhatt H, Bisht P, Mathew K, Nadella RK, Varghese AM, K V, Purushottam M, Jain S, Sud R, Viswanath B, Viswanath B, Rao NP, Narayanaswamy JC, Sivakumar PT, Kandasamy A, Kesavan M, Mehta UM, Venkatasubramanian G, John JP, Purushottam M, Mukherjee O, Mehta B, Kandavel T, Binukumar B, Saini J, Jayarajan D, Shyamsundar A, Moirangthem S, Vijay Kumar KG, Mahadevan J, Holla B, Thirthalli J, Chandra PS, Gangadhar BN, Murthy P, Panicker MM, Bhalla US, Chattarji S, Benegal V, Varghese M, Reddy JYC, Padinjat R, Rao M, Jain S. Abnormalities in migration of neural precursor cells in familial bipolar disorder. Dis Model Mech 2022; 15:277960. [PMID: 36239094 PMCID: PMC9612872 DOI: 10.1242/dmm.049526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/22/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Cellular migration is a ubiquitous feature that brings brain cells into appropriate spatial relationships over time; and it helps in the formation of a functional brain. We studied the migration patterns of induced pluripotent stem cell-derived neural precursor cells (NPCs) from individuals with familial bipolar disorder (BD) in comparison with healthy controls. The BD patients also had morphological brain abnormalities evident on magnetic resonance imaging. Time-lapse analysis of migrating cells was performed, through which we were able to identify several parameters that were abnormal in cellular migration, including the speed and directionality of NPCs. We also performed transcriptomic analysis to probe the mechanisms behind the aberrant cellular phenotype identified. Our analysis showed the downregulation of a network of genes, centering on EGF/ERBB proteins. The present findings indicate that collective, systemic dysregulation may produce the aberrant cellular phenotype, which could contribute to the functional and structural changes in the brain reported for bipolar disorder. This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Salil K Sukumaran
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Pradip Paul
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vishwesha Guttal
- Centre for Ecological Sciences, Indian Institute of Science, Bangalore, India.,Centre for Biosystems and Bioengineering, Indian Institute of Science, Bangalore, India
| | - Bharath Holla
- Dept. of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Alekhya Vemula
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Harsimar Bhatt
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Piyush Bisht
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kezia Mathew
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ravi K Nadella
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anu Mary Varghese
- Dept. of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijayalakshmi K
- Dept. of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Meera Purushottam
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjeev Jain
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Reeteka Sud
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Biju Viswanath
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Biju Viswanath
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Naren P Rao
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | - Arun Kandasamy
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | | | - John P John
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Meera Purushottam
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Odity Mukherjee
- Institute for Stem Cell Biology and Regenerative Medicine (InStem), India
| | - Bhupesh Mehta
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - B Binukumar
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Jitender Saini
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Deepak Jayarajan
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - A Shyamsundar
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - K G Vijay Kumar
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Jayant Mahadevan
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Bharath Holla
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - Prabha S Chandra
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | - Pratima Murthy
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | - Sumantra Chattarji
- Institute for Stem Cell Biology and Regenerative Medicine (InStem), India
| | - Vivek Benegal
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | - Mathew Varghese
- National Institute of Mental Health and Neurosciences (NIMHANS), India
| | | | | | - Mahendra Rao
- Institute for Stem Cell Biology and Regenerative Medicine (InStem), India
| | - Sanjeev Jain
- National Institute of Mental Health and Neurosciences (NIMHANS), India
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11
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Prasannakumar A, Korann V, Jacob A, Bharath RD, Kumar V, Varambally S, Venkatasubramanian G, Rao NP. Relation between frontal pole volumes and cognitive insight in Schizophrenia. Asian J Psychiatr 2022; 76:103204. [PMID: 35907267 DOI: 10.1016/j.ajp.2022.103204] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 07/03/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Cognitive insight comprising self-reflection and self-certainty is an important determinant of functional outcomes in Schizophrenia. The neural correlates of cognitive insight in Schizophrenia are underexamined. The frontal pole (FP) is implicated in metacognitive function in healthy individuals, but its role is not well examined in Schizophrenia. We had earlier reported the relationship between Frontal pole volumes and cognitive insight in a small sample of only male patients. Hence, we studied this relationship in an independent sample of schizophrenia patients and healthy controls. METHODS We examined 41 healthy volunteers (HV) and 57 patients with Schizophrenia (SCZ). We used a previously validated manual morphometric method to perform FP parcellation on images obtained from a 3 T scanner and calculated the volumes. Cognitive insight was measured using Beck's Cognitive insight scale (BCIS). To assess the relationship between FP volumes and BCIS scores, multiple linear regression analyses were performed. RESULTS In the overall sample, age, years of education, and intracranial volume were significant predictors of BCIS scores. Within the SCZ group, age and left FP volume were significant predictors of BCIS composite scores and age, ICV for BCIS-self certainty. There was no significant relationship between age and FP volumes in either SCZ or HV group. DISCUSSION The current study in an independent sample further supports the critical role of the frontal pole in cognitive insight, earlier reported by us. As cognitive insight has a vital role in functional outcome, our findings have potential clinical implications.
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Affiliation(s)
- Akash Prasannakumar
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vittal Korann
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Rose Dawn Bharath
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
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12
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Daderwal MC, Sreeraj VS, Suhas S, Rao NP, Venkatasubramanian G. Montreal Cognitive Assessment (MoCA) and Digit Symbol Substitution Test (DSST) as a screening tool for evaluation of cognitive deficits in schizophrenia. Psychiatry Res 2022; 316:114731. [PMID: 35926360 DOI: 10.1016/j.psychres.2022.114731] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 07/02/2022] [Accepted: 07/16/2022] [Indexed: 11/28/2022]
Abstract
Cognitive deficit is one of the core features of schizophrenia and is associated with poor functional outcomes. There is a lack of validated criteria to screen and monitor cognitive deficits in schizophrenia. This study aimed to evaluate the concurrent validity and sensitivity of MoCA (Montreal Cognitive Assessment) and DSST (Digit Symbol Substitution Test) in identifying cognitive deficits in Schizophrenia comparing with a comprehensive MCCB [MATRICS (Measurement And Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery] equivalent battery. We did clinical and cognitive assessments on 30 patients with schizophrenia and 30 age and gender-matched healthy controls. The Cronbach's Alpha of MoCA was 0.839, and on adding the DSST, it increased to 0.859. In stepwise binary logistic regression, adding DSST to MoCA improved the prediction of cognitive impairment as defined by a comprehensive battery with 86.7% classification accuracy. Receiver operating characteristic curve analysis suggested a score of 25 of MoCA and 59 of DSST as an optimal cut-off in identifying severe cognitive deficits with an additional MoCA cut-off of 27 for identifying mild cognitive deficits. Combined MoCA and DSST is a sensitive and quick method to screen for neurocognitive deficits in schizophrenia.
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Affiliation(s)
| | - Vanteemar S Sreeraj
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Satish Suhas
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Naren P Rao
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Ganesan Venkatasubramanian
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
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13
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Korann V, Jacob A, Lu B, Devi P, Thonse U, Nagendra B, Maria Chacko D, Dey A, Padmanabha A, Shivakumar V, Dawn Bharath R, Kumar V, Varambally S, Venkatasubramanian G, Deshpande G, Rao NP. Effect of Intranasal Oxytocin on Resting-state Effective Connectivity in Schizophrenia. Schizophr Bull 2022; 48:1115-1124. [PMID: 35759349 PMCID: PMC9434443 DOI: 10.1093/schbul/sbac066] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Evidence from several lines of research suggests the critical role of neuropeptide oxytocin in social cognition and social behavior. Though a few studies have examined the effect of oxytocin on clinical symptoms of schizophrenia, the underlying neurobiological changes are underexamined. Hence, in this study, we examined the effect of oxytocin on the brain's effective connectivity in schizophrenia. METHODS 31 male patients with schizophrenia (SCZ) and 21 healthy male volunteers (HV) underwent resting functional magnetic resonance imaging scans with intra-nasal oxytocin (24 IU) and placebo administered in counterbalanced order. We conducted a whole-brain effective connectivity analysis using a multivariate vector autoregressive granger causality model. We performed a conjunction analysis to control for spurious changes and canonical correlation analysis between changes in connectivity and clinical and demographic variables. RESULTS Three connections, sourced from the left caudate survived the FDR correction threshold with the conjunction analysis; connections to the left supplementary motor area, left precentral gyrus, and left frontal inferior triangular gyrus. At baseline, SCZ patients had significantly weaker connectivity from caudate to these three regions. Oxytocin, but not placebo, significantly increased the strength of connectivity in these connections. Better cognitive insight and lower negative symptoms were associated with a greater increase in connectivity with oxytocin. CONCLUSIONS These findings provide a preliminary mechanistic understanding of the effect of oxytocin on brain connectivity in schizophrenia. The study findings provide the rationale to examine the potential utility of oxytocin for social cognitive deficits in schizophrenia.
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Affiliation(s)
| | | | - Bonian Lu
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - Priyanka Devi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Umesh Thonse
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Bhargavi Nagendra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Dona Maria Chacko
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Avyarthana Dey
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Anantha Padmanabha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Venkataram Shivakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Rose Dawn Bharath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Naren P Rao
- To whom correspondence should be addressed; tel: +91-80-26995879, e-mail:
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14
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Appaji A, Harish V, Korann V, Devi P, Jacob A, Padmanabha A, Kumar V, Varambally S, Venkatasubramanian G, Rao SV, Suma HN, Webers CAB, Berendschot TTJM, Rao NP. Deep learning model using retinal vascular images for classifying schizophrenia. Schizophr Res 2022; 241:238-243. [PMID: 35176722 DOI: 10.1016/j.schres.2022.01.058] [Citation(s) in RCA: 4] [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: 08/19/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 12/13/2022]
Abstract
Contemporary psychiatric diagnosis still relies on the subjective symptom report of the patient during a clinical interview by a psychiatrist. Given the significant variability in personal reporting and differences in the skill set of psychiatrists, it is desirable to have objective diagnostic markers that could help clinicians differentiate patients from healthy individuals. A few recent studies have reported retinal vascular abnormalities in patients with schizophrenia (SCZ) using retinal fundus images. The goal of this study was to use a trained convolution neural network (CNN) deep learning algorithm to detect SCZ using retinal fundus images. A total of 327 subjects [139 patients with Schizophrenia (SCZ) and 188 Healthy volunteers (HV)] were recruited, and retinal images were acquired using a fundus camera. The images were preprocessed and fed to a convolution neural network for the classification. The model performance was evaluated using the area under the receiver operating characteristic curve (AUC). The CNN achieved an accuracy of 95% for classifying SCZ and HV with an AUC of 0.98. Findings from the current study suggest the potential utility of deep learning to classify patients with SCZ and assist clinicians in clinical settings. Future studies need to examine the utility of the deep learning model with retinal vascular images as biomarkers in schizophrenia with larger sample sizes.
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Affiliation(s)
- Abhishek Appaji
- Department of Medical Electronics Engineering, B.M.S. College of Engineering, Bangalore, India
| | - Vaishak Harish
- Department of Medical Electronics Engineering, B.M.S. College of Engineering, Bangalore, India
| | - Vittal Korann
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Priyanka Devi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anantha Padmanabha
- Department of Medical Electronics Engineering, B.M.S. College of Engineering, Bangalore, India
| | - Vijay Kumar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | - Shyam Vasudeva Rao
- University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - H N Suma
- Department of Medical Electronics Engineering, B.M.S. College of Engineering, Bangalore, India
| | - Caroll A B Webers
- University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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15
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Singh A, Kumar V, Pathak H, Jacob AA, Venkatasubramanian G, Varambally S, Rao NP. Effect of antipsychotic dose reduction on cognitive function in schizophrenia. Psychiatry Res 2022; 308:114383. [PMID: 34999291 DOI: 10.1016/j.psychres.2021.114383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/19/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 12/28/2022]
Abstract
Cognitive deficits are predictors of social functioning but remain an unmet therapeutic challenge. While lowering the antipsychotics carries a risk of relapse, it possibly has a beneficial effect on cognitive function. However, this has not been examined in a real-world setting. A prospective naturalistic 6-month follow-up study (n = 71) was conducted with patients between 18 and 45 years in their first five years of illness and the maintenance phase of the treatment. Brief Assessment of Cognition in Schizophrenia (BACS) was administered to assess cognitive functions. Patients were divided into three groups based on the change in dose of antipsychotics. The data were analyzed using linear mixed-effects modeling (LMEM) to examine the group differences. At the end of six months, those with decreased antipsychotic dose had significant improvement in BACS total score, token test, and symbol coding compared to those with no change in the dose of antipsychotic. Reducing the dose of antipsychotics during the maintenance phase was associated with improved cognitive functions without an increased risk of relapse. Antipsychotic dose reduction may be better than discontinuation as the relapse risk is higher with the discontinuation strategy. Clinicians must balance the improvements in cognitive functions and relapse risk.
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Affiliation(s)
- Animisha Singh
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijay Kumar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Harsh Pathak
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha A Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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16
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Affiliation(s)
- Satish Suhas
- Telementoring for Rural Health Organizers of Chhattisgarh Project, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India; Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India.
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India
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17
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Weber CJ, Carrillo MC, Jagust W, Jack CR, Shaw LM, Trojanowski JQ, Saykin AJ, Beckett LA, Sur C, Rao NP, Mendez PC, Black SE, Li K, Iwatsubo T, Chang C, Sosa AL, Rowe CC, Perrin RJ, Morris JC, Healan AM, Hall SE, Weiner MW. The Worldwide Alzheimer's Disease Neuroimaging Initiative: ADNI-3 updates and global perspectives. Alzheimers Dement (N Y) 2021; 7:e12226. [PMID: 35005206 PMCID: PMC8719344 DOI: 10.1002/trc2.12226] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/05/2021] [Indexed: 11/06/2022]
Abstract
The Worldwide Alzheimer's Disease Neuroimaging Initiative (WW-ADNI) is a collaborative effort to investigate imaging and biofluid markers that can inform Alzheimer's disease treatment trials. It is a public-private partnership that spans North America, Argentina, Australia, Canada, China, Japan, Korea, Mexico, and Taiwan. In 2004, ADNI researchers began a naturalistic, longitudinal study that continues today around the globe. Through several successive phases (ADNI-1, ADNI-GO, ADNI-2, and ADNI-3), the study has fueled amyloid and tau phenotyping and refined neuroimaging methodologies. WW-ADNI researchers have successfully standardized analyses and openly share data without embargo, providing a rich data set for other investigators. On August 26, 2020, the Alzheimer's Association convened WW-ADNI researchers who shared updates from ADNI-3 and their vision for ADNI-4.
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Affiliation(s)
| | | | - William Jagust
- School of Public Health and Helen Wills Neuroscience InstituteUniversity of California BerkeleyBerkeleyCaliforniaUSA
| | | | - Leslie M. Shaw
- Department of Pathology and Laboratory MedicinePerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - John Q. Trojanowski
- Department of Pathology and Laboratory MedicinePerelman School of MedicineInstitute on AgingPerelman School of MedicineAlzheimer's Disease Core Center, Perelman School of MedicineUdall Parkinson's Research CenterPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences and the Indiana Alzheimer's Disease Research CenterDepartment of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Laurel A. Beckett
- Division of BiostatisticsDepartment of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
| | - Cyrille Sur
- Merck Research LaboratoriesMerckKenilworthNew JerseyUSA
| | - Naren P. Rao
- Department of PsychiatryNational Institute of Mental Health and NeurosciencesBengaluruKarnatakaIndia
| | | | - Sandra E. Black
- Department of Medicine (Neurology)Hurvitz Brain Sciences ProgramCanadian Partnership for Stroke Recovery, and LC Campbell Cognitive Neurology Research UnitHurvitz Brain Sciences Research ProgramSunnybrook Research InstituteSunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada
| | - Kuncheng Li
- Department of RadiologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Takeshi Iwatsubo
- Department of NeuropathologyGraduate School of MedicineThe University of TokyoTokyoJapan
| | - Chiung‐Chih Chang
- Department of General Neurology and Institute for Translational Research in BiomedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Ana Luisa Sosa
- National Institute of Neurology and Neurosurgery of MexicoMexico CityMexico
| | - Christopher C. Rowe
- Department of Molecular Imaging and TherapyAustin Health and Florey Department of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Richard J. Perrin
- Charles F. and Joanne Knight Alzheimer Disease Research CenterDepartment of Pathology and ImmunologyDepartment of NeurologyWashington University School of MedicineSaint LouisMissouriUSA
| | - John C. Morris
- Charles F. and Joanne Knight Alzheimer Disease Research CenterDepartment of NeurologyWashington University School of MedicineSaint LouisMissouriUSA
| | | | | | - Michael W. Weiner
- Department of Veterans Affairs Medical CenterCenter for Imaging of Neurodegenerative DiseasesDepartment of RadiologyDepartment of MedicineDepartment of PsychiatryDepartment of NeurologyUniversity of CaliforniaSan FranciscoCaliforniaUSA
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18
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Tiwari V, Rao NP, M.L. A, Ravindranath V. Progression in WMH volume is accompanied by higher gray matter loss: One‐year follow‐up MRI study in TATA Longitudinal Study on Aging Cohort of India. Alzheimers Dement 2021. [DOI: 10.1002/alz.053396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Vivek Tiwari
- Centre for Brain Research Indian Institute of Science Bangalore India
| | - Naren P. Rao
- National Institute of Mental Health and Neurosciences Bangalore India
| | - Abhishek M.L.
- Centre for Brain Research Indian Institute of Science Bangalore India
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19
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Korann V, Appaji A, Jacob A, Devi P, Nagendra B, Chako DM, Padmanabha A, Thonse U, Bharath RD, Kumar V, Varambally S, Venkatasubramanian G, Rao SV, Webers CAB, Berendschot TTJM, Rao NP. Association between retinal vascular caliber and brain structure in schizophrenia. Asian J Psychiatr 2021; 61:102707. [PMID: 34052670 DOI: 10.1016/j.ajp.2021.102707] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/11/2021] [Accepted: 05/21/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Several lines of research in the last decade have indicated the potential utility of retina as a window to the brain. Emerging evidence suggests abnormalities in retinal vascular caliber in schizophrenia. However, the relationship between retinal vascular measures and brain structure has not been examined in schizophrenia to date. Hence, we examined the relationship between retinal vasculature measured using fundus photography and brain structure measured using magnetic resonance imaging. METHOD We recruited 17 healthy volunteers and 20 patients with schizophrenia. Using a non-mydriatic camera, we captured the images for left and right eyes separately and retinal vascular calibers were calculated using a semi-automated software package. Whole-brain anatomical T1 MPRAGE images were acquired using a 3-Tesla MRI scanner. Whole-brain and regional volume and cortical thickness were calculated using the Freesurfer software package. We used FreeSurfer's QDEC interface to compute vertex-by-vertex for analysis of the volume and cortical thickness. The relation between brain volume, cortical thickness, and retinal vascular caliber was examined using partial correlation and regression analysis. RESULTS There was a significant negative correlation between average CRVE and global cortical mean thickness in schizophrenia but not in healthy. In schizophrenia patients, there was a significant negative correlation between average CRVE and cortical thickness in frontal regions - left rostral middle frontal, left superior frontal, and right caudal middle frontal gyri and posterior brain regions - left lateral occipital gyrus and left posterior cingulate cortex. DISCUSSION The findings of the study suggest potential utility of retinal venular diameter as a proxy marker to abnormal neurodevelopment in schizophrenia.
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Affiliation(s)
- Vittal Korann
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Abhishek Appaji
- Department of Medical Electronics, BMS College of Engineering, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Priyanka Devi
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Dona Maria Chako
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ananth Padmanabha
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Umesh Thonse
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Rose Dawn Bharath
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijay Kumar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | - Shyam Vasudeva Rao
- Department of Medical Electronics, BMS College of Engineering, Bangalore, India
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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20
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Kumar P, Nagaraj C, Joshi R, Goud NS, Kumar D, Korann V, Mangalore S, Rao NP. Radiosynthesis of [18F]flumazenil for imaging benzodiazepine receptors and its evaluation in human volunteers using simultaneous PET-MRI. J Radioanal Nucl Chem 2021. [DOI: 10.1007/s10967-021-07859-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Rao NP, Ramachandran P, Jacob A, Joseph A, Thonse U, Nagendra B, Chako DM, Shiri S, Hassan H, Sreenivas V, Maran S, Durgam D, Nandakumar K, Varambally S, Gangadhar BN. Add on yoga treatment for negative symptoms of schizophrenia: A multi-centric, randomized controlled trial. Schizophr Res 2021; 231:90-97. [PMID: 33831770 DOI: 10.1016/j.schres.2021.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 09/28/2020] [Revised: 02/28/2021] [Accepted: 03/27/2021] [Indexed: 11/18/2022]
Abstract
The efficacy of antipsychotic medications in the treatment of negative symptoms of schizophrenia is modest at best. Preliminary studies suggest the beneficial effects of add on Yoga, a traditional Indian practice, in the treatment of schizophrenia. Hence, in this study, we examined the efficacy of yoga as an add-on treatment for negative symptoms of schizophrenia in a randomized, wait-list controlled design from two clinical institutes in south India. 89 patients (age - 34.20 ± 8.06 years; education - 14.22 ± 2.69 years; 28 females) were randomized into the add-on yoga or treatment as usual (TAU - wait-list control) group. Patients had a mean illness duration of 10.97 ± 7.24 years with an age at onset of 23.34 ± 5.81 years. Central block randomization was followed to ensure concealed allocation. Participants randomized to the yoga treatment group attended 12 supervised yoga training sessions over two weeks and practiced yoga sessions at home for the subsequent 10 weeks. 64 patients completed the trial. An intent to treat analysis was conducted with 89 participants using a linear mixed model. Improvement in negative symptoms was our primary outcome measure. The two groups were matched on demographic variables and baseline psychopathology severity. Participants in the add-on yoga group had significantly greater improvement in negative symptoms (SANS baseline: 49.13 ± 2.30; 12-weeks follow up: 31.55 ± 2.53) compared to the TAU group (SANS baseline: 51.22 ± 2.40; 12-weeks follow up: 45.30 ± 2.93; t = 3.36; p = 0.006; Cohen's d-0.65). The current study findings suggest the efficacy of yoga as an add-on treatment for negative symptoms of schizophrenia. The effectiveness of yoga practice as a regular clinical intervention for patients needs to be explored in future studies by integrating yoga services along with other clinical services.
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Affiliation(s)
- Naren P Rao
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | | | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Albert Joseph
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Umesh Thonse
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Dona M Chako
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sahana Shiri
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Habla Hassan
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | | | - Sindhu Maran
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | | | | | - Shivarama Varambally
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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22
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Grover S, Mehra A, Sahoo S, Avasthi A, Rao TSS, Vaishnav M, Dalal PK, Saha G, Singh OP, Chakraborty K, Janardran Reddy YC, Rao NP, Tripathi A, Chadda RK, Mishra KK, Rao GP, Kumar V, Gautam S, Sarkar S, Krishnan V, Subramanyam A. Evaluation of Psychological Impact of COVID-19 on Health-Care Workers. Indian J Psychiatry 2021; 63:222-227. [PMID: 34211213 PMCID: PMC8221203 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_1129_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/12/2020] [Revised: 09/19/2020] [Accepted: 03/02/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Little information is available from India about the psychological impact of COVID-19 on helath-care workers. AIM The current study aimed to evaluate the psychological issues among the health-care workers (HCW) during the COVID-19 pandemic. MATERIALS AND METHODS An online survey using Survey Monkey® platform was carried out to evaluate depression (using Patient Health Questionnaire-9), anxiety (using Generalized Anxiety Disorder Questionnaire-7), and other psychological issues (using a self-designed questionnaire). RESULTS The study sample comprised 303 participants with a mean age of 41.2 (standard deviation: 11.1) years. A majority of them were male (69%) and married (79.9%). Nearly half (46.2%) of the participants had either anxiety disorder or depression or both and 12.9% of HCW had suicidal behavior. Higher level of anxiety and depression scores were associated with being female, having undergone quarantine, directly involved in the care of COVID-19 patients, and younger age (<30 years). Higher prevalence of depression and anxiety disorder was seen in younger (<30 years) age group, being a doctor (compared to paramedics). In addition, higher prevalence of depression was seen in those who were directly involved in the care of patients with COVID-19 infection. CONCLUSION About half of the HCWs are suffering from psychiatric morbidity, specifically anxiety, in the wake of the COVID-19 pandemic. There is a need to assess all the HCWs for psychiatric morbidity and provide them with psychological support.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Aseem Mehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Ajit Avasthi
- Department of Psychiatry, CMC, Chandigarh, Punjab, India
- Department of Psychiatry, Fortis Hospital, Mohali, Punjab, India
| | - T. S. Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, India
| | - Mrugesh Vaishnav
- Samvedana Group of Hospital and Research Centre, Ahmadabad, Gujarat, India
| | - P. K. Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gautam Saha
- Clinic Brain Neuropsychiatric Institute and Research Center, Kolkata, India
| | | | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and JNM Hospital, WBUHS, Kalyani, West Bengal, India
| | | | - Naren P. Rao
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rakesh K. Chadda
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - K. K. Mishra
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Wardha, India
| | | | | | - Shiv Gautam
- Gautam Hospital and Research Center, Jaipur, Rajasthan, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Krishnan
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Alka Subramanyam
- Department of Psychiatry, TNMC and BYL Nair Ch. Hospital, Mumbai, Maharashtra, India
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23
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Suhas S, Kumar V, Damodharan D, Sharma P, Rao NP, Varambally S, Venkatasubramanian G, Murthy P, Gangadhar BN. Comment on: "Elevated Clozapine Concentrations in Clozapine-Treated Patients with Hypersalivation". Clin Pharmacokinet 2021; 60:1073-1075. [PMID: 33899164 DOI: 10.1007/s40262-021-01021-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Satish Suhas
- Schizophrenia and Metabolic Clinics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India
| | - Vijay Kumar
- Schizophrenia and Metabolic Clinics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India.
| | - Dinakaran Damodharan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Priyamvada Sharma
- Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Naren P Rao
- Schizophrenia and Metabolic Clinics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India
| | - Shivarama Varambally
- Schizophrenia and Metabolic Clinics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India
| | - Ganesan Venkatasubramanian
- Schizophrenia and Metabolic Clinics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560029, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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24
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Purushothaman D, Jacob AA, Kumar V, Varambally S, Venkatasubramanian G, Rao NP. The dilemma of self vs others' interest: Altruistic behaviour in schizophrenia and the role of vasopressin. Schizophr Res 2021; 230:77-78. [PMID: 33711680 DOI: 10.1016/j.schres.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/30/2021] [Accepted: 02/15/2021] [Indexed: 12/01/2022]
Affiliation(s)
| | - Arpitha A Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijay Kumar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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25
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Raju VB, Shukla A, Jacob A, Bharath RD, Kumar VK, Varambally S, Venkatasubramanian G, Rao NP. The frontal pole and cognitive insight in schizophrenia. Psychiatry Res Neuroimaging 2021; 308:111236. [PMID: 33340961 DOI: 10.1016/j.pscychresns.2020.111236] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 06/18/2020] [Revised: 11/23/2020] [Accepted: 12/11/2020] [Indexed: 12/22/2022]
Abstract
Absence of insight owing to impaired self-reflection and lack of touch with reality is a hallmark of schizophrenia. Functional imaging studies in healthy individuals have implicated the frontal pole (FP), sub-division of the prefrontal cortex in self-reflective processes. Despite the significance of self-referential processing in the pathogenesis of schizophrenia, the relationship between FP volume and cognitive insight in this disorder is underexplored. We examined the relationship between cognitive insight and volume of FP using precise manual morphometry of high resolution magnetic resonance images in 19 schizophrenia patients (SCZ) and 21 healthy-volunteers (HV). The manual morphometry technique was replicated from a previous study based on a cytoarchitectonically and functionally valid definition of FP and cognitive insight was measured using Beck's cognitive insight scale. Left frontal pole volume was a significant predictor of self-reflection sub-score of Beck's cognitive insight scale (β=0.68; t = 2.86; p = 0.01). A significant inverse relationship between age and bilateral FP volumes was noted in HV (left FP - r=-0.45; p = 0.04; right FP - r=-0.57; p = 0.008) but not in SCZ (p>0.05). Our findings provide anatomical substrates to devise intervention strategies targeting cognitive insight, thereby improving treatment adherence and functional outcomes.
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Affiliation(s)
- Vikas B Raju
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ayushi Shukla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijay Kg Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
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26
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Kumar V, Nichenmetla S, Chhabra H, Sreeraj VS, Rao NP, Kesavan M, Varambally S, Venkatasubramanian G, Gangadhar BN. Prefrontal cortex activation during working memory task in schizophrenia: A fNIRS study. Asian J Psychiatr 2021; 56:102507. [PMID: 33388563 DOI: 10.1016/j.ajp.2020.102507] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 04/15/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 11/19/2022]
Abstract
Neurocognitive cognitive deficits including working memory (WM) impairment is a key component of schizophrenia (SCZ). Though a prefrontal cortex (PFC) abnormality is recognised to contribute to WM impairment, the exact nature of its neurobiological basis in SCZ is not well established. Functional near infra-red spectroscopy (fNIRS) is an emerging low-cost neuroimaging tool to study neuro-hemodynamics. In this background, we examined the hemodynamic activity during a WM task in schizophrenia using fNIRS. fNIRS was acquired during computerised N-back (zero-, one- & two-back) task in 15 SCZ patients and compared with 22 healthy controls. Performance in N-back test were calculated using signal detection theory alongside the mean reaction times. Concentration and latencies of oxy-, deoxy-, and totalhaemoglobin, and oxygen saturation were computed from 8*8 optodes positioned over bilateral PFC. SCZ performed poorly as measured by most of the WM parameters (p < 0.05). Lesser deoxyhemoglobin concentration (two > zero, at right BA10, p = 0.006) was noted in the right frontopolar cortex in SCZ surviving multiple-comparison correction. In addition, olanzapine equivalent doses correlated negatively with right frontopolar cortex activation (two > zero back, BA10, ρ = 0.70, p = 0.004) and better performance in two back (false alarm rate, ρ = 0.61, p = 0.015). A delayed but compensatory hyperactivation of right frontopolar cortex noted in SCZ may underlie the WM deficit in SCZ. Future studies are recommended to replicate the role of right frontopolar cortex in WM using larger samples and systematically explore the effect of antipsychotics on them.
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Affiliation(s)
- Vijay Kumar
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India.
| | - Sonika Nichenmetla
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
| | - Harleen Chhabra
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
| | - Vanteemar S Sreeraj
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
| | - Naren P Rao
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
| | - Muralidharan Kesavan
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
| | - Shivarama Varambally
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
| | - Ganesan Venkatasubramanian
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
| | - Bangalore N Gangadhar
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of mental health and neurosciences (NIMHANS), Bengaluru, India
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27
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Suhas S, Nagpal M, Rao NP, Kumar V. Echo of reading - The forgotten psychopathology: A case report. Schizophr Res 2021; 228:602-603. [PMID: 33308960 DOI: 10.1016/j.schres.2020.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India
| | - Malvika Nagpal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560 029, India.
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28
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Abstract
OBJECTIVES The primary objective was to conduct a meta-analysis of studies comparing the GABA levels of schizophrenia patients (SZP) and healthy controls (HC) using proton magnetic resonance spectroscopy (1H-MRS) in the frontal cortex (FC) and its sub-regions. METHODS We included studies published in English language that used 1H-MRS from MRI scanners having at-least 3 Tesla (3 T) magnetic field strength to measure GABA levels in SZP (n = 699) and HC (n = 718) in FC and its sub-regions. The outcome measures were the means and standard deviations of GABA levels and outcome measure was calculated using a random-effect model. RESULTS In FC, medial prefrontal cortex (MPFC) and dorsolateral prefrontal cortex (DLPFC), there were no significant group differences. On excluding the outlier studies, the GABA levels were lower in patients with schizophrenia compared to healthy controls in FC (Hedges' g = -0.2; p = 0.02). In ACC, significant group difference was noted in GABA levels (Hedges' g = -0.25; p = 0.03) with patients values being lower that is more pronounced in the first episode schizophrenia patients (Hedges' g: -0.41; p = 0.003). CONCLUSIONS The available 1H-MRS studies suggest hypo-GABA ergia specifically in ACC and hint towards possible hypo GABA-ergic state in the FC. However, limitations of the analysis should be considered while interpreting the results.
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Affiliation(s)
- Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Bhavika Vajawat
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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29
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Holla B, Taylor PA, Glen DR, Lee JA, Vaidya N, Mehta UM, Venkatasubramanian G, Pal PK, Saini J, Rao NP, Ahuja CK, Kuriyan R, Krishna M, Basu D, Kalyanram K, Chakrabarti A, Orfanos DP, Barker GJ, Cox RW, Schumann G, Bharath RD, Benegal V. A series of five population-specific Indian brain templates and atlases spanning ages 6-60 years. Hum Brain Mapp 2020; 41:5164-5175. [PMID: 32845057 PMCID: PMC7670651 DOI: 10.1002/hbm.25182] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/27/2020] [Accepted: 08/10/2020] [Indexed: 12/16/2022] Open
Abstract
Anatomical brain templates are commonly used as references in neurological MRI studies, for bringing data into a common space for group‐level statistics and coordinate reporting. Given the inherent variability in brain morphology across age and geography, it is important to have templates that are as representative as possible for both age and population. A representative‐template increases the accuracy of alignment, decreases distortions as well as potential biases in final coordinate reports. In this study, we developed and validated a new set of T1w Indian brain templates (IBT) from a large number of brain scans (total n = 466) acquired across different locations and multiple 3T MRI scanners in India. A new tool in AFNI, make_template_dask.py, was created to efficiently make five age‐specific IBTs (ages 6–60 years) as well as maximum probability map (MPM) atlases for each template; for each age‐group's template–atlas pair, there is both a “population‐average” and a “typical” version. Validation experiments on an independent Indian structural and functional‐MRI dataset show the appropriateness of IBTs for spatial normalization of Indian brains. The results indicate significant structural differences when comparing the IBTs and MNI template, with these differences being maximal along the Anterior–Posterior and Inferior–Superior axes, but minimal Left–Right. For each age‐group, the MPM brain atlases provide reasonably good representation of the native‐space volumes in the IBT space, except in a few regions with high intersubject variability. These findings provide evidence to support the use of age and population‐specific templates in human brain mapping studies.
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Affiliation(s)
- Bharath Holla
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Paul A Taylor
- Scientific and Statistical Computing Core, NIMH, NIH, Bethesda, Maryland, USA
| | - Daniel R Glen
- Scientific and Statistical Computing Core, NIMH, NIH, Bethesda, Maryland, USA
| | - John A Lee
- Scientific and Statistical Computing Core, NIMH, NIH, Bethesda, Maryland, USA
| | - Nilakshi Vaidya
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India.,Centre for Population Neuroscience and Stratified Medicine (PONS), SGDP Centre, IoPPN, KCL, London, UK
| | | | | | - Pramod Kumar Pal
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Jitender Saini
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Naren P Rao
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Chirag K Ahuja
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rebecca Kuriyan
- St. John's Medical College and Research Institute, Bengaluru, India
| | - Murali Krishna
- CSI Holdsworth Memorial Hospital, Mysore, India.,Foundation for Research and Advocacy in Mental Health, Mysore, India
| | - Debashish Basu
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | - Gareth J Barker
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
| | - Robert W Cox
- Scientific and Statistical Computing Core, NIMH, NIH, Bethesda, Maryland, USA
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), SGDP Centre, IoPPN, KCL, London, UK
| | - Rose Dawn Bharath
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Vivek Benegal
- National Institute of Mental Health and Neuro Sciences, Bengaluru, India
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30
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Balakrishnan A, Tiwari V, Abhishek M, Rao NP, Ravindranath V. Role of white matter hyperintensities, hemoglobin and vitamin B‐12 on cognitive decline: Two‐year follow‐up data from the Tata Longitudinal Study of Ageing (TLSA). Alzheimers Dement 2020. [DOI: 10.1002/alz.045683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Vivek Tiwari
- Center for Brain Research Indian Institute of Science Bangalore India
| | | | - Naren P. Rao
- National Institute of Mental Health and Neurosciences Bangalore India
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31
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M.L. A, Balakrishnan A, Muralidhar SD, Rao NP, Ravindranath V. Relation between CAIDE scores and cognition: Data from TATA Longitudinal Study of Ageing. Alzheimers Dement 2020. [DOI: 10.1002/alz.045700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | - Naren P. Rao
- National Institute of Mental Health and Neurosciences Bangalore India
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32
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Sundarakumar J, Karunakaran S, ME S, R K, Sivakumar PT, Rao NP, Ravindranath V. Comparison of fasting blood sugar, HbA1c, vitamin B12, homocysteine and vitamin D in two parallel, aging study cohorts from rural and urban India: SANSCOG study and TLSA. Alzheimers Dement 2020. [DOI: 10.1002/alz.045724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Sumathi ME
- Sri Devaraj Urs Medical College Kolar India
| | - Kalyani R
- Sri Devaraj Urs Medical College Kolar India
| | | | - Naren P. Rao
- National Institute of Mental Health and Neurosciences Bangalore India
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33
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Sundarakumar J, Chauhan G, Rao GN, Sivakumar PT, Rao NP, Ravindranath V. Srinivaspura Aging, Neuro Senescence and COGnition (SANSCOG) study and Tata Longitudinal Study on Aging (TLSA): Study protocols. Alzheimers Dement 2020. [DOI: 10.1002/alz.045681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Ganesh Chauhan
- Centre for Brain Research Indian Institute of Science Bangalore India
| | - Girish N Rao
- National Institute of Mental Health and Neurosciences Bangalore India
| | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences Bangalore India
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Sundarakumar J, Sivakumar PT, Rao NP, Ravindranath V. Comparison of obesity, diabetes, hypertension and depression in two parallel, aging study cohorts from rural and urban India: SANSCOG study and TLSA. Alzheimers Dement 2020. [DOI: 10.1002/alz.045711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences Bangalore India
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Tiwari V, Kallur K, Rao NP, Sivakumar PT, Balakrishnan A, Ravindranath V. MRI investigations of white matter hyperintensity and structural abnormalities of brain in urban and rural cohorts of India. Alzheimers Dement 2020. [DOI: 10.1002/alz.045687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Vivek Tiwari
- Center for Brain Research Indian Institute of Science Bangalore India
| | - Kumar Kallur
- Healthcare Global Enterprises Ltd. Bangalore India
| | - Naren P Rao
- National Institute of Mental Health and Neurosciences Bangalore India
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Chaudhary K, Rao GN, Sivakumar PT, Sundarakumar J, Rao NP, Ravindranath V, Investigators SANSCOG. Approaches to overcome recruitment challenges in a rural setting in India: Strategies adopted in Srinivasapur Aging, Neuro Senescence and Cognition (SANSCOG) study. Alzheimers Dement 2020. [DOI: 10.1002/alz.045779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kiran Chaudhary
- Centre for Brain Research Indian Institute of Science Bangalore India
| | - Girish N Rao
- National Institute of Mental Health and Neurosciences Bangalore India
| | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences Bangalore India
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Zhivago KA, Shashidhara S, Garani R, Purokayastha S, Rao NP, Murthy A, Arun SP. Perceptual Priming Can Increase or Decrease With Aging. Front Aging Neurosci 2020; 12:576922. [PMID: 33328959 PMCID: PMC7711047 DOI: 10.3389/fnagi.2020.576922] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/30/2020] [Indexed: 11/13/2022] Open
Abstract
A decline in declarative or explicit memory has been extensively characterized in cognitive aging and is a hallmark of cognitive impairments. However, whether and how implicit perceptual memory varies with aging or cognitive impairment is unclear. Here, we compared implicit perceptual memory and explicit memory measures in three groups of participants: (1) 59 healthy young volunteers (20–30 years); (2) 269 healthy old volunteers (50–90 years) and (3) 21 patients with mild cognitive impairment, i.e., MCI (50–90 years). To measure explicit memory, participants were tested on standard recognition and recall tasks. To measure implicit perceptual memory, we used a classic perceptual priming paradigm. Participants had to report the shape of a visual search pop-out target whose color or position was varied randomly across trials. Perceptual priming was measured as the speedup in response time for targets that repeated in color or position. Our main findings are as follows: (1) Explicit memory was weaker in old compared to young participants, and in MCI patients compared to age- and education-matched controls; (2) Surprisingly, perceptual priming did not always decline with age: color priming was smaller in older participants but position priming was larger; (3) Position priming was less frequent in the MCI group compared to matched controls; (4) Perceptual priming and explicit memory were uncorrelated across participants. Thus, perceptual priming can increase or decrease with age or cognitive impairment, but these changes do not covary with explicit memory.
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Affiliation(s)
| | - Sneha Shashidhara
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
| | - Ranjini Garani
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
| | | | - Naren P. Rao
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Aditya Murthy
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
| | - S. P. Arun
- Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
- *Correspondence: S. P. Arun,
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Abstract
PURPOSE OF REVIEW To review the efficacy of add-on yoga therapy in improving symptoms of schizophrenia and quality of life and examine the possible underlying biological mechanisms of yoga in schizophrenia. RECENT FINDINGS Quality of life, cognitive symptoms, and negative symptoms have been found to improve with add-on yoga therapy in schizophrenia (pooled mean effect size 0.8, 0.6, and 0.4, respectively). Yoga also seems to have a small effect on improving positive symptoms. Less explored areas include adverse effects of yoga itself as well as its effects on antipsychotic-induced complications. Preliminary findings suggest that the effects of yoga may be mediated by neurohormonal mechanisms and functional changes in brain activity. Add-on yoga therapy is a potential treatment option for improving quality of life, cognitive symptoms, and negative symptoms in schizophrenia. Future studies should explore efficacy in multicentric trials as well as possible neurobiological changes underlying the effects.
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Affiliation(s)
- Ramajayam Govindaraj
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health & Neurosciences, Bengaluru, India
| | - Shivarama Varambally
- Department of Integrative Medicine, National Institute of Mental Health & Neurosciences, Bengaluru, India. .,Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India.
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India
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Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, Pattojoshi A, Rao GP, Saha G, Mishra KK, Chakraborty K, Rao NP, Vaishnav M, Singh OP, Dalal PK, Chadda RK, Gupta R, Gautam S, Sarkar S, Sathyanarayana Rao TS, Kumar V, Janardran Reddy YC. Comments on psychological impact of COVID-19 lockdown: An online survey from India. Indian J Psychiatry 2020; 62:595-596. [PMID: 33678849 PMCID: PMC7909019 DOI: 10.4103/psychiatry.indianjpsychiatry_1086_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 09/21/2020] [Accepted: 10/02/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
| | - Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
| | - Aseem Mehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
| | - Ajit Avasthi
- Department of Psychiatry, Fortis Hospital, Mohali, Punjab, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Alka Subramanyan
- Department of Psychiatry, TNMC and BYL Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Amrit Pattojoshi
- Department of Psychiatry, Hi-Tech Medical College, Bhubaneswar, Odisha, India
| | | | - Gautam Saha
- Clinic Brain Neuropsychiatric Institute and Research Center, Barasat, West Bengal, India
| | - K K Mishra
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and J.N.M Hospital, WBUHS, Kalyani, West Bengal, India
| | - Naren P Rao
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Mrugesh Vaishnav
- Samvedana Group of Hospital and Research Centre, Ahmadabad, Gujarat, India
| | - Om Prakash Singh
- Department of Psychiatry, NRS Medical College, Kolkata, West Bengal, India
| | - P K Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rakesh K Chadda
- Samvedana Group of Hospital and Research Centre, Ahmadabad, Gujarat, India
| | - Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shiv Gautam
- Gautam Hospital and Research Center, Jaipur, Rajasthan, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - T S Sathyanarayana Rao
- JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Achalia R, Raju VB, Jacob A, Nahar A, Achalia G, Nagendra B, Kaginalkar V, Choudhary S, Venkatasubramanian G, Rao NP. Comparison of first-episode and multiple-episode bipolar disorder: A surface-based morphometry study. Psychiatry Res Neuroimaging 2020; 302:111110. [PMID: 32505904 DOI: 10.1016/j.pscychresns.2020.111110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 03/27/2019] [Revised: 01/17/2020] [Accepted: 02/14/2020] [Indexed: 01/09/2023]
Abstract
It is still unclear whether the structural abnormalities in Bipolar disorder (BD) are static or progressive. We aimed to compare differences in cortical thickness, surface area, and volume between patients with BD and healthy volunteers (HV) and to examine whether there are differences between patients who have had a single manic episode and those with multiple episodes. We recruited 30 patients with Type I BD and 30 age and sex matched HV. All participants underwent structural magnetic resonance imaging. Cortical volume, thickness, and surface area were measured using the QDEC tool from the Freesurfer software with age and intracranial volume as covariates. Study groups were comparable across age, sex distribution, and intracranial volume. Patients had significantly lower surface area in bilateral cuneus, right postcentral gyrus, and rostral middle frontal gyri; and lower cortical volume in the left middle temporal gyrus, right postcentral gyrus, and right cuneus. BD patients with multiple episodes had lower cortical measures while those with single episode had cortical measures comparable to HV. Findings indicate that the pathophysiological processes in BD are possibly progressive in nature. Our findings underscore the potential importance of early diagnosis and intervention in preventing deterioration and improving functional recovery.
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Affiliation(s)
| | - Vikas B Raju
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Abhinav Nahar
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, Pattojoshi A, Rao GP, Saha G, Mishra KK, Chakraborty K, Rao NP, Vaishnav M, Singh OP, Dalal PK, Chadda RK, Gupta R, Gautam S, Sarkar S, Sathyanarayana Rao TS, Kumar V, Janardran Reddy YC. Psychological impact of COVID-19 lockdown: An online survey from India. Indian J Psychiatry 2020; 62:354-362. [PMID: 33165368 PMCID: PMC7597717 DOI: 10.4103/psychiatry.indianjpsychiatry_427_20] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [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: 05/01/2020] [Revised: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to a complete shut-down of the entire world and almost all the countries are presently in a "lockdown" mode. While the lockdown strategy is an essential step to curb the exponential rise of COVID-19 cases, the impact of the same on mental health is not well known. AIM This study aimed to evaluate the psychological impact of lockdown due to COVID-19 pandemic on the general public with an objective to assess the prevalence of depression, anxiety, perceived stress, well-being, and other psychological issues. MATERIALS AND METHODS It was an online survey conducted under the aegis of the Indian Psychiatry Society. Using the Survey Monkey platform, a survey link was circulated using the Whatsapp. The survey questionnaire included perceived stress scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Warwick-Edinburgh Mental Well-being Scale to assess perceived stress, anxiety, depression, and mental well-being, respectively. The survey link was circulated starting from April 6, 2020 and was closed on April 24, 2020. RESULTS During the survey, a total of 1871 responses were collected, of which 1685 (90.05%) responses were analyzed. About two-fifth (38.2%) had anxiety and 10.5% of the participants had depression. Overall, 40.5% of the participants had either anxiety or depression. Moderate level of stress was reported by about three-fourth (74.1%) of the participants and 71.7% reported poor well-being. CONCLUSIONS The present survey suggests that more than two-fifths of the people are experiencing common mental disorders, due to lockdown and the prevailing COVID-19 pandemic. This finding suggests that there is a need for expanding mental health services to everyone in the society during this pandemic situation.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - Aseem Mehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | | | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Alka Subramanyan
- Department of Psychiatry, TNMC and BYL Nair Ch. Hospital, Mumbai, Maharashtra, India
| | - Amrit Pattojoshi
- Department of Psychiatry, Hi-Tech Medical College, Bhubaneswar, Odisha, India
| | | | - Gautam Saha
- Clinic Brain Neuropsychiatric Institute and Research Center, Barasat, West Bengal, India
| | - K K Mishra
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and J.N.M Hospital, WBUHS, Kalyani, West Bengal, India
| | - Naren P Rao
- Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Mrugesh Vaishnav
- Samvedana Group of Hospital and Research Centre, Ahmadabad, Gujarat, India
| | - Om Prakash Singh
- Department of Psychiatry, NRS Medical College, Kolkata, West Bengal, India
| | - P K Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rakesh K Chadda
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shiv Gautam
- Gautam hospital and Research Center, Jaipur, Rajasthan, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - T S Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Kumar V, Manchegowda S, Jacob A, Rao NP. Glutamate metabolites in treatment resistant schizophrenia: A meta-analysis and systematic review of 1H-MRS studies. Psychiatry Res Neuroimaging 2020; 300:111080. [PMID: 32279055 DOI: 10.1016/j.pscychresns.2020.111080] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 07/02/2019] [Revised: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
Nearly a third to half of schizophrenia patients are non-responsive to first-line antipsychotics and are labelled treatment resistant schizophrenia (TRS). Neurochemical abnormalities in TRS may not be dopaminergic but possibly glutamate (Glu) related. Studies that have examined glutamatergic abnormalities using proton magnetic resonance spectroscopy (1H-MRS) in TRS, have showed inconsistent results. Hence, we conducted a meta-analysis of 1H-MRS studies comparing levels of Glu-and its metabolites in the brains of TRS and non-treatment resistant schizophrenia (nTRS) patients. Four eligible studies were included in the analysis. Summary effect size for the group difference between TRS (n = 101, including Ultra-TRS) and nTRS (n = 61) in Glu-levels in the anterior cingulate cortex (ACC) as measured with Hedges's g was 0.21 (95% CI: -0.42 to 0.85; p = 0.5) suggesting absence of significant difference. However, on leave one out analysis, one iteration showed significant difference in Glu-levels between the groups (Hedges's g = 0.46; p = 0.02) with higher Glu-levels in TRS implying significant effect of a single study on the effect size. The higher ACC Glu-in TRS was not associated with symptom severity or antipsychotic administration, indicating a possible trait abnormality. The limited number of datasets comparing Glu-metabolites in other brain regions are narratively described. Our analysis is limited by the significant heterogeneity between studies. Further longitudinal, prospective studies are needed to confirm higher Glu-metabolite levels in ACC in TRS and explore this potential trait abnormality.
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Affiliation(s)
- Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shayanth Manchegowda
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
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Thanki MV, Baliga SP, Parameshwaran S, Rao NP, Mehta UM, Thirthalli J. Safe administration of low frequency rTMS in a patient with depression with recurrent antidepressant-associated hyponatremic seizures. Brain Stimul 2020; 13:1168-1169. [PMID: 32502719 DOI: 10.1016/j.brs.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/14/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022] Open
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Achalia R, Sinha A, Jacob A, Achalia G, Kaginalkar V, Venkatasubramanian G, Rao NP. A proof of concept machine learning analysis using multimodal neuroimaging and neurocognitive measures as predictive biomarker in bipolar disorder. Asian J Psychiatr 2020; 50:101984. [PMID: 32143176 DOI: 10.1016/j.ajp.2020.101984] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 07/02/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Concomitant use of complementary, multimodal imaging measures and neurocognitive measures is reported to have higher accuracy as a biomarker in Alzheimer's dementia. However, such an approach has not been examined to differentiate healthy individuals from Bipolar disorder. In this study, we examined the utility of support vector machine (SVM) technique to differentiate bipolar disorder patients and healthy using structural, functional and diffusion tensor images of brain and neurocognitive measures. METHODS 30 patients with Bipolar disorder-I and 30 age, sex matched individuals participated in the study. Structural MRI, resting state functional MRI and diffusion tensor images were obtained using a 1.5 T scanner. All participants were administered neuropsychological tests to measure executive functions. SVM, a supervised machine learning technique was applied to differentiate patients and healthy individuals with k-fold cross validation over 10 trials. RESULTS The composite marker consisting of both neuroimaging and neuropsychological measures, had an accuracy of 87.60 %, sensitivity of 82.3 % and specificity of 92.7 %. The performance of composite marker was better compared to that of individual markers on classificatory. CONCLUSIONS We were able to achieve a high accuracy for machine learning technique in distinguishing BD from HV using a combination of multimodal neuroimaging and neurocognitive measures. Findings of this proof of concept study, if replicated in larger samples, could have potential clinical applications.
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Affiliation(s)
| | - Anannya Sinha
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Garimaa Achalia
- Achalia Neuropsychiatry Hospital, Aurangabad, Maharashtra, India
| | | | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, India.
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Sreeraj VS, Bose A, Chhabra H, Shivakumar V, Agarwal SM, Narayanaswamy JC, Rao NP, Kesavan M, Varambally S, Venkatasubramanian G. Working memory performance with online-tDCS in schizophrenia: A randomized, double-blinded, sham-controlled, partial cross-over proof-of-concept study. Asian J Psychiatr 2020; 50:101946. [PMID: 32087502 DOI: 10.1016/j.ajp.2020.101946] [Citation(s) in RCA: 10] [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] [Received: 11/03/2019] [Accepted: 02/08/2020] [Indexed: 12/12/2022]
Abstract
Combining cognitive retraining with transcranial direct current stimulation (tDCS) has been hypothesized to improve cognitive deficits in schizophrenia. The effect of combining a neuropsychological/psychophysiological task with tDCS, called "online-tDCS" for cognitive enhancement in schizophrenia is not rigorously assessed. In this proof-of-concept study, we aimed at evaluating the effect of a single session online-tDCS on working memory(WM) and its transferability to other cognitive functions. Numerical n-back(NNB), digit symbol substitution test(DSST), emotional matching and labelling test(E-MALT), and anti-saccade eye movement beeforefore and after 20 min tDCS (anode: left dorsolateral prefrontal cortex and cathode: left temporoparietal junction) applied during Sternberg's task(WM-task) were assessed. Twenty-three schizophrenia patients with cognitive deficits were randomized to receive either online-tDCS or offline-tDCS (without simultaneous Sternberg's task) sessions. All patients received one session each of active and sham tDCS in a randomized counterbalanced double-blind cross-over design. RMANOVA revealed a significant interaction effect between tDCS type (Online/Offline) x activeness (active/sham) of tDCS; the reaction time during 2-back performance in the NNB test improved in online-sham (F = 5.23, p < 0.038) but not online-active tDCS session. No significant changes were noted in DSST, E-MALT, and anti-saccade performance. Improved performance after online-sham tDCS suggests that performing the Sternberg's task enhanced 2-back performance. The counterintuitive observation was noted with respect to the non-enhancement of WM performance on combining the task to tDCS. Aberrant plasticity in schizophrenia might attain a transitional ceiling that would have resulted in restriction of enhancement on combining the two plasticity modulators. The transferability of improvement to other cognitive domains could not be ascertained.
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Affiliation(s)
- Vanteemar S Sreeraj
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
| | - Anushree Bose
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Harleen Chhabra
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Venkataram Shivakumar
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Sri Mahavir Agarwal
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Janardhanan C Narayanaswamy
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Naren P Rao
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Muralidharan Kesavan
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- WISER Neuromodulation Program, Translational Psychiatry Laboratory, Neurobiology Research Center, InSTAR Program, Schizophrenia & Metabolic Clinic, Department of Psychiatry National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Patil VA, Jacob AA, Chacko DM, Chakrabarti D, Devi P, Thonse U, Kumar V, Varambally S, Venkatasubramanian G, Rao NP. Examination of social decision making in patients with schizophrenia using ultimatum game. Asian J Psychiatr 2020; 50:101937. [PMID: 32109802 DOI: 10.1016/j.ajp.2020.101937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/22/2019] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
Intact decision-making skills in the social context are essential for optimal functioning in the community. Despite its significance, social decision making in schizophrenia (SCZ) has not been adequately examined. Hence, we examined social decision making in SCZ using the Ultimatum Game(UG), a neuroeconomic paradigm that involves financial transactions between a proposer and a responder to split a sum of money between them. Thirty male patients with a diagnosis of schizophrenia as per DSM-IV (age = 30 ± 7.08) and thirty age-matched healthy male volunteers (HV;age = 28.48 ± 3.74) participated in the study. All participants functioned as responders and had to either accept or reject offers made by an anonymous proposer. We also examined whether the gender or emotional expression of the proposer influenced acceptance rates. SCZ had significantly lower acceptance rates than HV for slightly unequal offers (t = 3.94, p = < 0.0001). However, there was no significant difference between SCZ and HV for other offers. Gender and emotional expression of the proposer did not significantly influence the outcome. These results suggest aberrant social decision making and increased inequity aversion in patients with SCZ. The difficulty in incorporating social components while engaging in financial interactions could have important implications for rehabilitation, functional recovery, and successful community living in SCZ.
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Affiliation(s)
- Vaishnavi A Patil
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Arpitha Anna Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Dona Maria Chacko
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Priyanka Devi
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Umesh Thonse
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
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Simha A, Prasad R, Ahmed S, Rao NP. Effect of gender and clinical-financial vulnerability on mental distress due to COVID-19. Arch Womens Ment Health 2020; 23:775-777. [PMID: 33420600 PMCID: PMC7794077 DOI: 10.1007/s00737-020-01097-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has had an enormous impact on people's mental health. This study examines whether gender influences the mental distress in people from at-risk populations (clinically high risk and financially vulnerable). A cross-sectional survey was administered between the 23rd and 28th of April 2020 to 15,691 individuals from 32,596 households in the UK. Our findings confirmed that individuals who are clinically high risk or financially vulnerable or a combination of both experience significantly higher levels of mental distress. Additionally, we also found that females experienced higher levels of mental distress than males across various categories.
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Affiliation(s)
| | - Ramakrishna Prasad
- PCMH Restore Health, National Center for Primary Care Research & Policy, Academy of Family Physicians of India (AFPI), Bengaluru, India
| | | | - Naren P. Rao
- National Institute of Mental Health and Neurosciences, Bengaluru, India
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Appaji A, Nagendra B, Chako DM, Padmanabha A, Jacob A, Hiremath CV, Varambally S, Kesavan M, Venkatasubramanian G, Rao SV, Webers CAB, Berendschot TTJM, Rao NP. Examination of retinal vascular trajectory in schizophrenia and bipolar disorder. Psychiatry Clin Neurosci 2019; 73:738-744. [PMID: 31400288 DOI: 10.1111/pcn.12921] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 05/08/2019] [Revised: 07/24/2019] [Accepted: 08/06/2019] [Indexed: 12/11/2022]
Abstract
AIM Evidence suggests microvascular dysfunction (wider retinal venules and narrower arterioles) in schizophrenia (SCZ) and bipolar disorder (BD). The vascular development is synchronous with neuronal development in the retina and brain. The retinal vessel trajectory is related to retinal nerve fiber layer thinning and cerebrovascular abnormalities in SCZ and BD and has not yet been examined. Hence, in this study we examined the retinal vascular trajectory in SCZ and BD in comparison with healthy volunteers (HV). METHODS Retinal images were acquired from 100 HV, SCZ patients, and BD patients, respectively, with a non-mydriatic fundus camera. Images were quantified to obtain the retinal arterial and venous trajectories using a validated, semiautomated algorithm. Analysis of covariance and regression analyses were conducted to examine group differences. A supervised machine-learning ensemble of bagged-trees method was used for automated classification of trajectory values. RESULTS There was a significant difference among groups in both the retinal venous trajectory (HV: 0.17 ± 0.08; SCZ: 0.25 ± 0.17; BD: 0.27 ± 0.20; P < 0.001) and the arterial trajectory (HV: 0.34 ± 0.15; SCZ: 0.29 ± 0.10; BD: 0.29 ± 0.11; P = 0.003) even after adjusting for age and sex (P < 0.001). On post-hoc analysis, the SCZ and BD groups differed from the HV on retinal venous and arterial trajectories, but there was no difference between SCZ and BD patients. The machine learning showed an accuracy of 86% and 73% for classifying HV versus SCZ and BD, respectively. CONCLUSION Smaller trajectories of retinal arteries indicate wider and flatter curves in SCZ and BD. Considering the relation between retinal/cerebral vasculatures and retinal nerve fiber layer thinness, the retinal vascular trajectory is a potential marker for SCZ and BD. As a relatively affordable investigation, retinal fundus photography should be further explored in SCZ and BD as a potential screening measure.
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Affiliation(s)
- Abhishek Appaji
- Department of Medical Electronics, B. M. S. College of Engineering, Bangalore, India.,University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Bhargavi Nagendra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Dona M Chako
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ananth Padmanabha
- Department of Medical Electronics, B. M. S. College of Engineering, Bangalore, India
| | - Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Chaitra V Hiremath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Muralidharan Kesavan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Shyam V Rao
- Department of Medical Electronics, B. M. S. College of Engineering, Bangalore, India.,University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
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Appaji A, Nagendra B, Chako DM, Padmanabha A, Hiremath CV, Jacob A, Varambally S, Kesavan M, Venkatasubramanian G, Rao SV, Webers CAB, Berendschot TTJM, Rao NP. Retinal vascular fractal dimension in bipolar disorder and schizophrenia. J Affect Disord 2019; 259:98-103. [PMID: 31445346 DOI: 10.1016/j.jad.2019.08.061] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 03/26/2019] [Revised: 06/14/2019] [Accepted: 08/18/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bipolar disorder (BD) and schizophrenia (SCZ), are associated with greater vascular co-morbidities and adverse vascular events. Owing to shared developmental origins and morphology, retinal vasculature is a proxy assessment measure of the cerebral vasculature. Although retinal vascular fractal dimension (Df), a measure of vascular geometry and complexity of branching, has been shown to be directly associated with cerebrovascular pathology, it has not been examined in SCZ and BD. METHODS We studied 277 participants (92 healthy volunteers, 98 SCZ, and 87 BD) from 18 to 50 years of age. Images were acquired by trained personnel using a non-mydriatic fundus camera and the retinal vascular Df was calculated by the box-counting method using an automated algorithm. The average Df across the left and right eyes were calculated. RESULTS Both SCZ and BD had significantly increased Df compared to HV despite controlling for possible confounding factors. However, there was no significant difference between SCZ and BD. These findings suggest abnormal retinal vascular Df in psychoses. LIMITATIONS The study design was cross-sectional, and patients were on medications. Confound of lifestyle factors such as diet and exercise, if any, was not controlled. Sub-group analysis between BD-I and BD-II was not performed in view of the small sample. CONCLUSIONS Considering the easy accessibility, affordability, and non-invasive nature of the examination, retinal vascular Df could serve as a surrogate marker for cerebral vascular abnormality and could potentially identify BD and SCZ patients at risk of developing adverse vascular events.
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Affiliation(s)
- Abhishek Appaji
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore, India; University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Bhargavi Nagendra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Dona Maria Chako
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ananth Padmanabha
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore, India
| | - Chaitra V Hiremath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Muralidharan Kesavan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Shyam Vasudeva Rao
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore, India; University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
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50
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Achalia RM, Jacob A, Achalia G, Sable A, Venkatasubramanian G, Rao NP. Investigating spontaneous brain activity in bipolar disorder: A resting-state functional magnetic resonance imaging study. Indian J Psychiatry 2019; 61:630-634. [PMID: 31896871 PMCID: PMC6862975 DOI: 10.4103/psychiatry.indianjpsychiatry_391_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Despite several neuroimaging studies in the past few years, the exact pathophysiology responsible for the development of bipolar disorder (BD) is still not completely known. Importantly, to the best of our knowledge, no study from India has examined resting state (RS) connectivity abnormalities in BD using regional homogeneity (ReHo). Hence, we examined spontaneous brain activity in patients with BD using RS functional magnetic resonance imaging (RS-fMRI). AIM The aim of the study is to examine the spontaneous brain activity in patients with BD-I using ReHo approach and RS-fMRI compared to age- and gender-matched healthy control (HC). MATERIALS AND METHODS A total of 20 patients with BD and 20 age-, gender-, and education-matched HCs participated in the study. The fMRI data were obtained using 1.5T scanner. RS-fMRI abnormalities were analyzed using ReHo method. RESULTS Compared to healthy adults, significantly increased ReHo in the BD group was found in the right precuneus, right insula, right supramarginal gyrus, left superior frontal gyrus, right inferior frontal gyrus, right precentral gyrus, and right paracentral lobule. No region had significantly lower ReHo values in BD patients compared to controls. CONCLUSION These results suggested that abnormal local synchronization of spontaneous brain activity is present in the frontoparietoinsular region which may be related to the pathophysiology of BD.
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Affiliation(s)
| | - Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Garimaa Achalia
- Achalia Neuropsychiatry Clinic, Aurangabad, Maharashtra, India
| | - Abhijit Sable
- Department of Psychiatry, Government Medical College, Aurangabad, Maharashtra, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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