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Miley K, Bronstein MV, Ma S, Lee H, Green MF, Ventura J, Hooker CI, Nahum M, Vinogradov S. Trajectories and predictors of response to social cognition training in people with schizophrenia: A proof-of-concept machine learning study. Schizophr Res 2024; 266:92-99. [PMID: 38387253 PMCID: PMC11005939 DOI: 10.1016/j.schres.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 12/15/2023] [Accepted: 02/17/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Social cognition training (SCT) can improve social cognition deficits in schizophrenia. However, little is known about patterns of response to SCT or individual characteristics that predict response. METHODS 76 adults with schizophrenia randomized to receive 8-12 weeks of remotely-delivered SCT were included in this analysis. Social cognition was measured with a composite of six assessments. Latent class growth analyses identified trajectories of social cognitive response to SCT. Random forest and logistic regression models were trained to predict membership in the trajectory group that showed improvement from baseline measures including symptoms, functioning, motivation, and cognition. RESULTS Five trajectory groups were identified: Group 1 (29 %) began with slightly above average social cognition, and this ability significantly improved with SCT. Group 2 (9 %) had baseline social cognition approximately one standard deviation above the sample mean and did not improve with training. Groups 3 (18 %) and 4 (36 %) began with average to slightly below-average social cognition and showed non-significant trends toward improvement. Group 5 (8 %) began with social cognition approximately one standard deviation below the sample mean, and experienced significant deterioration in social cognition. The random forest model had the best performance, predicting Group 1 membership with an area under the curve of 0.73 (SD 0.24; 95 % CI [0.51-0.87]). CONCLUSIONS Findings suggest that there are distinct patterns of response to SCT in schizophrenia and that those with slightly above average social cognition at baseline may be most likely to experience gains. Results may inform future research seeking to individualize SCT treatment for schizophrenia.
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Affiliation(s)
- Kathleen Miley
- HealthPartners Institute, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, MN, USA.
| | - Michael V Bronstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, MN, USA
| | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, MN, USA
| | - Hyunkyu Lee
- Department of Research and Development, Posit Science Inc., San Francisco, CA, USA
| | - Michael F Green
- VA Greater Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Mor Nahum
- School of Occupational Therapy, Hebrew University of Jerusalem, Israel
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, MN, USA
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Meyer-Kalos P, Owens G, Fisher M, Wininger L, Williams-Wengerd A, Breen K, Abate J, Currie A, Olinger N, Vinogradov S. Putting measurement-based care into action: A mixed methods study of the benefits of integrating routine client feedback in coordinated specialty care programs for early psychosis. Res Sq 2024:rs.3.rs-3918063. [PMID: 38405727 PMCID: PMC10889084 DOI: 10.21203/rs.3.rs-3918063/v1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Background Measurement-based care (MBC) is an effective tool in the delivery of evidence-based practices (EBPs). MBC utilizes feedback loops to share information and drive changes throughout a learning healthcare system. Few studies have demonstrated this practice in team-based care for people with early psychosis. This paper describes the development of a personalized feedback report derived from routine assessments that is shared with clients and clinicians as part of a MBC process. Methods We used a quasi pre-post comparison design with mixed methods to evaluate the implementation of a personalized feedback report at 5 early psychosis coordinated specialty care programs (CSC). We compared clients enrolled in CSC who did and did not receive a feedback report over the first 6 months of treatment. The sample included 204 clients: 146 who did not receive the feedback report and were enrolled over 2 years, and 58 who received the feedback report. A subset of 67 clients completed measures at both intake and 6-month follow-up, including 42 who received the report and 25 who did not. We compared the two groups with regard to self-reported symptoms, likelihood of completing treatment, and perception of shared decision making. We conducted qualitative interviews with 5 clients and 5 clinicians to identify the benefits and challenges associated with the personalized feedback report. Results People who received a personalized feedback report reported significant improvements in shared decision-making and had greater improvements over time in their intent to attend future treatment sessions. They engaged in more sessions for Supported Employment and Education (SEE), case management, and peer support, and fewer medication visits over the first 6 months of treatment. Both groups showed significant improvement in symptoms and functioning. Results from the qualitative analysis indicated that the experience of receiving the reports was valuable and validating for both patients and clinicians. Conclusions A personalized feedback report was integrated into standard of care for early psychosis programs. This process may improve shared decision-making, strengthen the likelihood to stay in treatment, and increase engagement in psychosocial interventions. We posit that this process facilitates strengths-focused discussions, enhances intrinsic motivation, and strengthens the therapeutic alliance.
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Polack RG, Bronstein MV, Questel M, Edelman A, Vinogradov S, Kober H, Joormann J, Everaert J. Social interpretation inflexibility moderates emotional reactions to social situations in children and adolescents. Dev Psychopathol 2023; 35:2352-2364. [PMID: 37466071 PMCID: PMC10796842 DOI: 10.1017/s0954579423000834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Interpretation biases and inflexibility (i.e., difficulties revising interpretations) have been linked to increased internalizing symptoms. Although adolescence is a developmental period characterized by novel social situations and increased vulnerability to internalizing disorders, no studies have examined interpretation inflexibility in adolescents. Additionally, no studies (on adolescents or adults) have examined interpretation flexibility as a protective factor against adverse outcomes of interpersonal events. Using a novel task and a 28-day diary we examined relations among interpretation bias and inflexibility, internalizing symptoms, and negative interpersonal events in a sample of children and adolescents (N = 159, ages 9-18). At baseline, negative interpretation bias was positively correlated with social anxiety symptoms, and positive interpretation bias negatively correlated with social anxiety and depressive symptoms. Inflexible positive interpretations were correlated with higher social anxiety and depressive symptoms, while inflexible negative interpretations were correlated with higher social anxiety. Finally, interpretation inflexibility moderated daily associations between negative interpersonal events and depressive symptoms in daily life, such that higher inflexibility was associated with stronger associations between interpersonal events and subsequent depressive symptoms, potentially increasing depressive symptom instability. These results suggest that interpretation biases and inflexibility may act as both risk and protective factors for adolescent anxiety and depression.
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Affiliation(s)
- Reuma Gadassi Polack
- Department of Psychology, Yale University, Connecticut, USA
- School of Behavioral Sciences, Tel-Aviv Yaffo Academic College, Tel-Aviv Yaffo, Israel
| | - Michael V. Bronstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minnesota, USA
| | - Marcia Questel
- Department of Psychology, Yale University, Connecticut, USA
| | - Audrey Edelman
- Department of Psychology, Yale University, Connecticut, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minnesota, USA
| | - Hedy Kober
- Department of Psychology, Yale University, Connecticut, USA
- Department of Psychiatry, Yale University, Connecticut, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, Connecticut, USA
| | - Jonas Everaert
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Belgium
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Vinogradov S. Harnessing neuroplasticity. Psychiatry Res 2023; 330:115607. [PMID: 38000206 DOI: 10.1016/j.psychres.2023.115607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/26/2023]
Abstract
Twenty years ago, cognitive impairments were recognized as an unmet treatment need in schizophrenia. Basic science discoveries in neuroplasticity had led to cognitive training approaches for dyslexia. We wondered whether a similar approach could target working memory deficits in schizophrenia by harnessing plasticity in the auditory cortex. Our per protocol experimental therapeutics studies tested the hypothesis that sharpening auditory cortical representations would result in better verbal learning and memory. We also later studied the effects of intensive training of basic social cognitive operations. Our training protocols were deliberately focused, effortful and intensive, since participants were often up against decades of cortical dysplasticity. In studies in different stages of illness, we demonstrated that neuroscience-informed cognitive training was associated with: (1) proximal psychophysical as well as distal cognitive improvements; (2) increases in serum BDNF levels; (3) negative effects of serum anticholinergic burden; (4) electrophysiologic responses and brain activation patterns consistent with restorative neuroplastic changes in cortex; (5) positive cortical and thalamic volumetric changes suggestive of neuroprotection; (6) better 6-month clinical functioning in those with a positive initial response. Taken together, this work indicates how much the field of psychiatry could benefit from a deep understanding of the basic science of cortical neuroplasticity processes and of how they can be deliberately and efficiently harnessed for therapeutic purposes.
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Affiliation(s)
- Sophia Vinogradov
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, United States.
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5
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Fisher M, Etter K, Murray A, Ghiasi N, LaCross K, Ramsay I, Currie A, Fitzpatrick K, Biagianti B, Schlosser D, Loewy R, Vinogradov S. The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial. J Med Internet Res 2023; 25:e48634. [PMID: 37955951 PMCID: PMC10682932 DOI: 10.2196/48634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/14/2023] [Accepted: 09/26/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Impairments in cognition and motivation are core features of psychosis and strong predictors of social and occupational functioning. Accumulating evidence indicates that cognitive deficits in psychosis can be improved by computer-based cognitive training programs; however, barriers include access and adherence to cognitive training exercises. Limited evidence-based methods have been established to enhance motivated behavior. In this study, we tested the effects of web-based targeted cognitive and social cognitive training (TCT) delivered in conjunction with an innovative digital smartphone app called Personalized Real-Time Intervention for Motivational Enhancement (PRIME). The PRIME app provides users with a motivational coach to set personalized goals and secure social networking for peer support. OBJECTIVE This study investigated whether deficits in cognition and motivation in people with a psychosis spectrum disorder (N=100) can be successfully addressed with 30 hours of TCT+PRIME as compared with 30 hours of a computer games control condition (CG) plus PRIME (CG+PRIME). Here, we describe our study procedures, the feasibility and acceptability of the intervention, and the results on all primary outcomes. METHODS In this double-blind randomized controlled trial, English-speaking participants completed all cognitive training, PRIME activities, and assessments remotely. Participants completed a diagnostic interview and remote cognitive, clinical, and self-report measures at baseline, posttraining, and at a 6-month follow-up. RESULTS This study included participants from 27 states across the United States and 8 countries worldwide. The study population was 58% (58/100) female, with a mean age of 33.77 (SD 10.70) years. On average, participants completed more than half of the cognitive training regimen (mean 18.58, SD 12.47 hours of training), and logged into the PRIME app 4.71 (SD 1.58) times per week. The attrition rate of 22% (22/100) was lower than that reported in our previous studies on remote cognitive training. The total sample showed significant gains in global cognition (P=.03) and attention (P<.001). The TCT+PRIME participants showed significantly greater gains in emotion recognition (P<.001) and global cognition at the trend level (P=.09), although this was not statistically significant, relative to the CG+PRIME participants. The total sample also showed significant improvements on multiple indices of motivation (P=.02-0.05), in depression (P=.04), in positive symptoms (P=.04), and in negative symptoms at a trend level (P=.09), although this was not statistically significant. Satisfaction with the PRIME app was rated at 7.74 (SD 2.05) on a scale of 1 to 10, with higher values indicating more satisfaction. CONCLUSIONS These results demonstrate the feasibility and acceptability of remote cognitive training combined with the PRIME app and that this intervention can improve cognition, motivation, and symptoms in individuals with psychosis. TCT+PRIME appeared more effective in improving emotion recognition and global cognition than CG+PRIME. Future analyses will test the relationship between hours of cognitive training completed; PRIME use; and changes in cognition, motivation, symptoms, and functioning. TRIAL REGISTRATION ClinicalTrials.gov NCT02782442; https://clinicaltrials.gov/study/NCT02782442.
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Affiliation(s)
- Melissa Fisher
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Kevin Etter
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Edgewood Center for Children and Families, San Francisco, CA, United States
| | - Aimee Murray
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Neelu Ghiasi
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Kristin LaCross
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ian Ramsay
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Ariel Currie
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Karrie Fitzpatrick
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Bruno Biagianti
- Department of Psychology, University of Milan Bicocca, Milano, Italy
| | - Danielle Schlosser
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Rachel Loewy
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Sophia Vinogradov
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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Hua JPY, Loewy RL, Stuart B, Fryer SL, Niendam TA, Carter CS, Vinogradov S, Mathalon DH. Cortical and subcortical brain morphometry abnormalities in youth at clinical high-risk for psychosis and individuals with early illness schizophrenia. Psychiatry Res Neuroimaging 2023; 332:111653. [PMID: 37121090 PMCID: PMC10362971 DOI: 10.1016/j.pscychresns.2023.111653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/27/2023] [Accepted: 04/18/2023] [Indexed: 05/02/2023]
Abstract
Neuroimaging studies have documented morphometric brain abnormalities in schizophrenia, but less is known about them in individuals at clinical high-risk for psychosis (CHR-P), including how they compare with those observed in early schizophrenia (ESZ). Accordingly, we implemented multivariate profile analysis of regional morphometric profiles in CHR-P (n = 89), ESZ (n = 93) and healthy controls (HC; n = 122). ESZ profiles differed from HC and CHR-P profiles, including 1) cortical thickness: significant level reduction and regional non-parallelism reflecting widespread thinning, except for entorhinal and pericalcarine cortex, 2) basal ganglia volume: significant level increase and regional non-parallelism reflecting larger caudate and pallidum, and 3) ventricular volume: significant level increase with parallel regional profiles. CHR-P and ESZ cerebellar profiles showed significant non-parallelism with HC profiles. Regional profiles did not significantly differ between groups for cortical surface area or subcortical volume. Compared to CHR-P followed for ≥18 months without psychosis conversion (n = 31), CHR-P converters (n = 17) showed significant non-parallel ventricular volume expansion reflecting specific enlargement of lateral and inferolateral regions. Antipsychotic dosage in ESZ was significantly correlated with frontal cortical thinning. Results suggest that morphometric abnormalities in ESZ are not present in CHR-P, except for ventricular enlargement, which was evident in CHR-P who developed psychosis.
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Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center, and the University of California, San Francisco, CA, United States; Mental Health Service, San Francisco VA Medical Center, San Francisco, 94121, CA, United States; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, 94143, CA, United States; Department of Psychological Sciences, University of Missouri, Columbia, 65211, MO, United States
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, 94143, CA, United States
| | - Barbara Stuart
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, 94143, CA, United States
| | - Susanna L Fryer
- Mental Health Service, San Francisco VA Medical Center, San Francisco, 94121, CA, United States
| | - Tara A Niendam
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, 95616, CA, United States
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California Davis, Davis, 95616, CA, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55455, MN, United States
| | - Daniel H Mathalon
- Mental Health Service, San Francisco VA Medical Center, San Francisco, 94121, CA, United States; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, 94143, CA, United States.
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Hua JPY, Cummings J, Roach BJ, Fryer SL, Loewy RL, Stuart BK, Ford JM, Vinogradov S, Mathalon DH. Rich-club connectivity and structural connectome organization in youth at clinical high-risk for psychosis and individuals with early illness schizophrenia. Schizophr Res 2023; 255:110-121. [PMID: 36989668 PMCID: PMC10705845 DOI: 10.1016/j.schres.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 11/07/2022] [Accepted: 03/08/2023] [Indexed: 03/31/2023]
Abstract
Brain dysconnectivity has been posited as a biological marker of schizophrenia. Emerging schizophrenia connectome research has focused on rich-club organization, a tendency for brain hubs to be highly-interconnected but disproportionately vulnerable to dysconnectivity. However, less is known about rich-club organization in individuals at clinical high-risk for psychosis (CHR-P) and how it compares with abnormalities early in schizophrenia (ESZ). Combining diffusion tensor imaging (DTI) and magnetic resonance imaging (MRI), we examined rich-club and global network organization in CHR-P (n = 41) and ESZ (n = 70) relative to healthy controls (HC; n = 74) after accounting for normal aging. To characterize rich-club regions, we examined rich-club MRI morphometry (thickness, surface area). We also examined connectome metric associations with symptom severity, antipsychotic dosage, and in CHR-P specifically, transition to a full-blown psychotic disorder. ESZ had fewer connections among rich-club regions (ps < .024) relative to HC and CHR-P, with this reduction specific to the rich-club even after accounting for other connections in ESZ relative to HC (ps < .048). There was also cortical thinning of rich-club regions in ESZ (ps < .013). In contrast, there was no strong evidence of global network organization differences among the three groups. Although connectome abnormalities were not present in CHR-P overall, CHR-P converters to psychosis (n = 9) had fewer connections among rich-club regions (ps < .037) and greater modularity (ps < .037) compared to CHR-P non-converters (n = 19). Lastly, symptom severity and antipsychotic dosage were not significantly associated with connectome metrics (ps < .012). Findings suggest that rich-club and connectome organization abnormalities are present early in schizophrenia and in CHR-P individuals who subsequently transition to psychosis.
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Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center and the University of California, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Jennifer Cummings
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Brian J Roach
- San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Susanna L Fryer
- San Francisco VA Medical Center, San Francisco, CA 94121, USA
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Barbara K Stuart
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Judith M Ford
- San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Daniel H Mathalon
- San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA.
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Affiliation(s)
- Sophia Vinogradov
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis
| | - Piper Meyer-Kalos
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School, Minneapolis
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Miley K, Meyer-Kalos P, Ma S, Bond DJ, Kummerfeld E, Vinogradov S. Causal pathways to social and occupational functioning in the first episode of schizophrenia: uncovering unmet treatment needs. Psychol Med 2023; 53:2041-2049. [PMID: 37310333 PMCID: PMC10106305 DOI: 10.1017/s0033291721003780] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND We aimed to identify unmet treatment needs for improving social and occupational functioning in early schizophrenia using a data-driven causal discovery analysis. METHODS Demographic, clinical, and psychosocial measures were obtained for 276 participants from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) trial at baseline and 6-months, along with measures of social and occupational functioning from the Quality of Life Scale. The Greedy Fast Causal Inference algorithm was used to learn a partial ancestral graph modeling causal relationships across baseline variables and 6-month functioning. Effect sizes were estimated using a structural equation model. Results were validated in an independent dataset (N = 187). RESULTS In the data-generated model, greater baseline socio-affective capacity was a cause of greater baseline motivation [Effect size (ES) = 0.77], and motivation was a cause of greater baseline social and occupational functioning (ES = 1.5 and 0.96, respectively), which in turn were causes of their own 6-month outcomes. Six-month motivation was also identified as a cause of occupational functioning (ES = 0.92). Cognitive impairment and duration of untreated psychosis were not direct causes of functioning at either timepoint. The graph for the validation dataset was less determinate, but otherwise supported the findings. CONCLUSIONS In our data-generated model, baseline socio-affective capacity and motivation are the most direct causes of occupational and social functioning 6 months after entering treatment in early schizophrenia. These findings indicate that socio-affective abilities and motivation are specific high-impact treatment needs that must be addressed in order to promote optimal social and occupational recovery.
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Affiliation(s)
- Kathleen Miley
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Piper Meyer-Kalos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - David J. Bond
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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Swerdlow NR, Bhakta SG, Talledo J, Benster L, Kotz J, Vinogradov S, Molina JL, Light GA. Auditory discrimination and frequency modulation learning in schizophrenia patients: amphetamine within-subject dose response and time course. Psychol Med 2023; 53:140-148. [PMID: 33849683 PMCID: PMC8514598 DOI: 10.1017/s0033291721001239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Auditory frequency modulation learning ('auditory learning') is a key component of targeted cognitive training (TCT) for schizophrenia. TCT can be effective in enhancing neurocognition and function in schizophrenia, but such gains require significant time and effort and elude many patients. METHODS As a strategy to increase and/or accelerate TCT-induced clinical gains, we tested the dose- and time-course effects of the pro-attentional drug, amphetamine (AMPH; placebo, 2.5, 5 or 10 mg po; within-subject double-blind, order balanced) on auditory learning in schizophrenia patients [n = 32; M:F = 19:13; age 42.0 years (24-55)]. To understand predictors and/or mechanisms of AMPH-enhanced TCT, we also measured auditory fidelity (words-in-noise (WIN), quick speech-in-noise (QuickSIN)) and neurocognition (MATRICS comprehensive cognitive battery (MCCB)). Some measures were also acquired from age-matched healthy subjects (drug free; n = 10; M:F = 5:5). RESULTS Patients exhibited expected deficits in neurocognition. WIN and QuickSIN performance at low signal intensities was impaired in patients with low v. high MCCB attention/vigilance (A/V) scores; these deficits were corrected by AMPH, maximally at 2.5-5 mg (d's = 0.79-1.29). AMPH also enhanced auditory learning, with maximal effects at 5 mg (d = 0.93), and comparable effects 60 and 210 min post pill. 'Pro-learning' effects of AMPH and AMPH-induced gains in auditory fidelity were most evident in patients with low MCCB A/V scores. CONCLUSIONS These findings advance our understanding of the impact of pro-attentional interventions on auditory information processing and suggest dose- and time-course parameters for studies that assess the ability of AMPH to enhance the clinical benefits of TCT in schizophrenia patients.
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Affiliation(s)
- Neal R. Swerdlow
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Savita G. Bhakta
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Jo Talledo
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Lindsay Benster
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Juliana Kotz
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Sophia Vinogradov
- Department of Psychiatry, School of Medicine, University of Minnesota, USA
| | - Juan L. Molina
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Gregory A. Light
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
- VISN-22 Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
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Vinogradov S, Chafee MV, Lee E, Morishita H. Psychosis spectrum illnesses as disorders of prefrontal critical period plasticity. Neuropsychopharmacology 2023; 48:168-185. [PMID: 36180784 PMCID: PMC9700720 DOI: 10.1038/s41386-022-01451-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 01/05/2023]
Abstract
Emerging research on neuroplasticity processes in psychosis spectrum illnesses-from the synaptic to the macrocircuit levels-fill key gaps in our models of pathophysiology and open up important treatment considerations. In this selective narrative review, we focus on three themes, emphasizing alterations in spike-timing dependent and Hebbian plasticity that occur during adolescence, the critical period for prefrontal system development: (1) Experience-dependent dysplasticity in psychosis emerges from activity decorrelation within neuronal ensembles. (2) Plasticity processes operate bidirectionally: deleterious environmental and experiential inputs shape microcircuits. (3) Dysregulated plasticity processes interact across levels of scale and time and include compensatory mechanisms that have pathogenic importance. We present evidence that-given the centrality of progressive dysplastic changes, especially in prefrontal cortex-pharmacologic or neuromodulatory interventions will need to be supplemented by corrective learning experiences for the brain if we are to help people living with these illnesses to fully thrive.
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Affiliation(s)
- Sophia Vinogradov
- Department of Psychiatry & Behavioral Science, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Matthew V Chafee
- Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Erik Lee
- Masonic Institute for the Developing Brain, University of Minnesota Medical School, Minneapolis, MN, USA
- University of Minnesota Informatics Institute, University of Minnesota, Minneapolis, MN, USA
| | - Hirofumi Morishita
- Department of Psychiatry, Neuroscience, & Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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12
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Jia Y, Kudo K, Hinkley LBN, Fisher M, Vinogradov S, Nagarajan S, Subramaniam K. Abnormal Information Flow in Schizophrenia Is Linked to Psychosis. Schizophr Bull 2022; 48:1384-1393. [PMID: 36073155 PMCID: PMC9673273 DOI: 10.1093/schbul/sbac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND HYPOTHESIS Prior research has shown that patients with schizophrenia (SZ) show disruption in brain network connectivity that is thought to underlie their cognitive and psychotic symptoms. However, most studies examining functional network disruption in schizophrenia have focused on the temporally correlated coupling of the strength of network connections. Here, we move beyond correlative metrics to assay causal computations of connectivity changes in directed neural information flow, assayed from a neural source to a target in SZ. STUDY DESIGN This study describes a whole-brain magnetoencephalography-imaging approach to examine causal computations of connectivity changes in directed neural information flow between brain regions during resting states, quantified by phase-transfer entropy (PTE) metrics, assayed from a neural source to an endpoint, in 21 SZ compared with 21 healthy controls (HC), and associations with cognitive and clinical psychotic symptoms in SZ. STUDY RESULTS We found that SZ showed significant disruption in information flow in alpha (8-12 Hz) and beta (12-30 Hz) frequencies, compared to HC. Reduced information flow in alpha frequencies from the precuneus to the medio-ventral occipital cortex was associated with more severe clinical psychopathology (ie, positive psychotic symptoms), while reduced information flow between insula and middle temporal gyrus was associated with worsening cognitive symptoms. CONCLUSIONS The present findings highlight the importance of delineating dysfunction in neural information flow in specific oscillatory frequencies between distinct regions that underlie the cognitive and psychotic symptoms in SZ, and provide potential neural biomarkers that could lead to innovations in future neuromodulation treatment development.
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Affiliation(s)
- Yingxin Jia
- Department of Radiology and Biomedical Imaging, University of California, San, Francisco, CA 94143, USA
| | - Kiwamu Kudo
- Department of Radiology and Biomedical Imaging, University of California, San, Francisco, CA 94143, USA
- Medical Imaging Business Center, Ricoh Company, Ltd., Kanazawa, Japan
| | - Leighton B N Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San, Francisco, CA 94143, USA
| | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Srikantan Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San, Francisco, CA 94143, USA
| | - Karuna Subramaniam
- Department of Psychiatry, University of California, San Francisco, CA 94143, USA
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13
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Miley K, Michalowski M, Yu F, Leng E, McMorris BJ, Vinogradov S. Predictive models for social functioning in healthy young adults: A machine learning study integrating neuroanatomical, cognitive, and behavioral data. Soc Neurosci 2022; 17:414-427. [PMID: 36196662 PMCID: PMC9707316 DOI: 10.1080/17470919.2022.2132285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 09/14/2022] [Indexed: 10/10/2022]
Abstract
Poor social functioning is an emerging public health problem associated with physical and mental health consequences. Developing prognostic tools is critical to identify individuals at risk for poor social functioning and guide interventions. We aimed to inform prediction models of social functioning by evaluating models relying on bio-behavioral data using machine learning. With data from the Human Connectome Project Healthy Young Adult sample (age 22-35, N = 1,101), we built Support Vector Regression models to estimate social functioning from variable sets of brain morphology to behavior with increasing complexity: 1) brain-only model, 2) brain-cognition model, 3) cognition-behavioral model, and 4) combined brain-cognition-behavioral model. Predictive accuracy of each model was assessed and the importance of individual variables for model performance was determined. The combined and cognition-behavioral models significantly predicted social functioning, whereas the brain-only and brain-cognition models did not. Negative affect, psychological wellbeing, extraversion, withdrawal, and cortical thickness of the rostral middle-frontal and superior-temporal regions were the most important predictors in the combined model. Results demonstrate that social functioning can be accurately predicted using machine learning methods. Behavioral markers may be more significant predictors of social functioning than brain measures for healthy young adults and may represent important leverage points for preventative intervention.
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Affiliation(s)
- Kathleen Miley
- School of Nursing, University of Minnesota, Minneapolis MN, United States
| | - Martin Michalowski
- School of Nursing, University of Minnesota, Minneapolis MN, United States
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Ethan Leng
- Department of Biomedical Engineering, University of Minnesota, Minneapolis MN, United States
| | | | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis MN, United States
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14
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Vinogradov S, Hamid AA, Redish AD. Etiopathogenic Models of Psychosis Spectrum Illnesses Must Resolve Four Key Features. Biol Psychiatry 2022; 92:514-522. [PMID: 35931575 PMCID: PMC9809152 DOI: 10.1016/j.biopsych.2022.06.024] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 01/07/2023]
Abstract
Etiopathogenic models for psychosis spectrum illnesses are converging on a number of key processes, such as the influence of specific genes on the synthesis of proteins important in synaptic functioning, alterations in how neurons respond to synaptic inputs and engage in synaptic pruning, and microcircuit dysfunction that leads to more global cortical information processing vulnerabilities. Disruptions in prefrontal operations then accumulate and propagate over time, interacting with environmental factors, developmental processes, and homeostatic mechanisms, eventually resulting in symptoms of psychosis and disability. However, there are 4 key features of psychosis spectrum illnesses that are of primary clinical relevance but have been difficult to assimilate into a single model and have thus far received little direct attention: 1) the bidirectionality of the causal influences for the emergence of psychosis, 2) the catastrophic clinical threshold seen in first episodes of psychosis and why it is irreversible in some individuals, 3) observed biotypes that are neurophysiologically distinct but clinically both convergent and divergent, and 4) a reconciliation of the role of striatal dopaminergic dysfunction with models of prefrontal cortical state instability. In this selective review, we briefly describe these 4 hallmark features and we argue that theoretically driven computational perspectives making use of both algorithmic and neurophysiologic models are needed to reduce this complexity and variability of psychosis spectrum illnesses in a principled manner.
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Affiliation(s)
- Sophia Vinogradov
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota.
| | - Arif A Hamid
- Department of Neuroscience, University of Minnesota Medical School, Minneapolis, Minnesota
| | - A David Redish
- Department of Neuroscience, University of Minnesota Medical School, Minneapolis, Minnesota
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15
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Abstract
“Schizophrenia” is used as a unitary diagnostic term for an illness that is extremely heterogeneous in its etiology, pathophysiology, presentation, and trajectory. Furthermore, the presence of psychosis—its hallmark characteristic—can be observed in individuals with other diagnoses, and biologically- and computationally-defined psychosis biotypes differ from those associated with DSM diagnoses and yield different treatment predictions. We argue that schizophrenia is not only stigmatizing as a label, it is not useful as a diagnostic term, a disease concept, or a construct for scientific research. Until we are able to delineate a range of dysfunctions across molecular/cellular and/or macrocircuit levels that map onto psychosis-proneness and indicate optimal treatment pathways, we propose to eliminate schizophrenia and replace it with a new nomenclature as an interim solution. Similar to what is done with other broad descriptive disease concepts in medicine which are defined by hallmark clinical features and then further subtyped (e.g., sickle cell anemia, iron deficiency anemia), we propose that psychosis spectrum illnesses (PSIs) be characterized by their temporal characteristics, relevant modifying/causal and symptom features, and treatment responsiveness.
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Affiliation(s)
- Jennifer L. Zick
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical Center, Minnesota, USA,Corresponding author
| | | | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical Center, Minnesota, USA
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16
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Bronstein MV, Everaert J, Kummerfeld E, Haynos AF, Vinogradov S. Biased and inflexible interpretations of ambiguous social situations: Associations with eating disorder symptoms and socioemotional functioning. Int J Eat Disord 2022; 55:518-529. [PMID: 35132668 PMCID: PMC9392902 DOI: 10.1002/eat.23688] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Research indicates that difficulties across multiple socioemotional functioning domains (e.g., social emotion expression/regulation, response to social elicitors of emotion) and negatively biased interpretations of ambiguous social situations may affect eating disorder symptoms. The impact of inflexible interpretations of social situations on eating disorder symptoms is less clear. The present study therefore examined relations between inflexible and biased social interpretations, socioemotional functioning, and eating disorder symptoms. METHOD A total of 310 participants from the general population, recruited from an online crowdsourcing platform, completed measures of socioemotional functioning (e.g., rejection sensitivity, negative social exchange), eating disorder symptoms, and positive and negative interpretation bias and inflexibility on a single measurement occasion. RESULTS Socioemotional functioning impairments (Pillai's trace = 0.11, p < .001), but not negative (β = .07, p = .162) or positive (β = -.01, p = .804) interpretation bias or inflexible interpretations (β = .04, p = .446), were associated with eating disorder symptoms in multiple regression models. In network analyses controlling statistically for multiple markers of socioemotional functioning, eating disorder symptoms were directly associated with negative (but not positive) interpretation bias. Inflexible interpretations were indirectly linked to symptoms via co-dampening of positive emotions. Exploratory causal discovery analyses suggested that several socioemotional functioning variables (social anxiety, depression, negative social exchange) may cause eating disorder symptoms. CONCLUSIONS Consistent with cognitive-interpersonal models of disordered eating, our results suggest that less accurate (biased, inflexible) interpretations of social information contribute to patterns of cognition (anxious anticipation of rejection) and emotion regulation (down-regulation of positive social emotion) thought to encourage disordered eating. PUBLIC SIGNIFICANCE This study suggests that less accurate interpretations of ambiguous social information encourage anxious anticipation of rejection and downregulation of positive social emotions, both of which are thought to promote eating disorder symptoms. Knowledge provided by this study about the likely relations between interpretive processes, social/emotional functioning, and eating disorder symptoms may help inform treatments for eating disorders, particularly those that attempt to modify patterns of interpretation.
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Affiliation(s)
- Michael V. Bronstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jonas Everaert
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | - Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ann F. Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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17
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Scoriels L, Genaro LT, Keffer S, Guimarães AL, Barros-Dumas B, Mororó LG, Biagioni T, Lucena C, da Hora TR, Sahakian BJ, Fisher M, Vinogradov S, Panizzutti R. Changes in emotion processing and social cognition with auditory versus visual neuroscience-informed cognitive training in individuals with schizophrenia. Schizophr Res 2022; 241:267-274. [PMID: 35182906 PMCID: PMC10664860 DOI: 10.1016/j.schres.2022.02.013] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Neuroscience-informed cognitive training has been used to remediate cognitive deficits in schizophrenia, but their effect on emotion processing and social cognition deficits, which may involve auditory and visual impairments, remain relatively unknown. In this study, we compared the efficacy of auditory versus visual neuroscience-informed cognitive training on emotion processing and social cognition in individuals with schizophrenia. METHODS In this randomised, double-blind clinical trial, 79 participants with chronic schizophrenia performed 40-hours auditory or visual dynamically equivalent computerised cognitive training. We assessed emotion processing and social cognition using Emotion Recognition, Affective Go-NoGo, Mayer-Salovey-Caruso Emotional-Intelligence, Theory of mind, and Hinting tests before and after 20 h and 40 h of training. RESULTS After training, participants from both groups decreased their reaction time for facial emotion recognition (p = 3 × 10-6, d = 0.9). This was more remarkable for the auditory group when analysing individual emotions. Both groups also reduced omissions in the affective go-no go (p = 0.01, d = 0.6), which was also attributed, post hoc, to the auditory group. Trends for improvement were observed in theory of mind (p = 0.06, d = 0.6) for both groups. Improvement in emotion processing was associated with improvement in reasoning and problem solving and global cognition and improvement in theory of mind was associated with improvement in attention and global cognition. CONCLUSIONS Both the auditory and the visual neuroscience-informed cognitive training were efficacious at improving emotion processing and social cognition in individuals with schizophrenia, although improvement was more remarkable for the auditory training group. These improvements were related to cognitive - but not symptom - improvement.
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Affiliation(s)
- Linda Scoriels
- Institut de Psychiatrie et Neurosciences de Paris, Inserm - Université Paris Descartes, France; Department of Psychiatry, University of Cambridge, United Kingdom; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil.
| | - Larissa T Genaro
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Stella Keffer
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Anna Luiza Guimarães
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Bárbara Barros-Dumas
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Luana G Mororó
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Thales Biagioni
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Camila Lucena
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | - Thaís R da Hora
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil
| | | | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, United States
| | | | - Rogério Panizzutti
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil.
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18
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Redish AD, Kepecs A, Anderson LM, Calvin OL, Grissom NM, Haynos AF, Heilbronner SR, Herman AB, Jacob S, Ma S, Vilares I, Vinogradov S, Walters CJ, Widge AS, Zick JL, Zilverstand A. Computational validity: using computation to translate behaviours across species. Philos Trans R Soc Lond B Biol Sci 2022; 377:20200525. [PMID: 34957854 PMCID: PMC8710889 DOI: 10.1098/rstb.2020.0525] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/28/2021] [Indexed: 11/12/2022] Open
Abstract
We propose a new conceptual framework (computational validity) for translation across species and populations based on the computational similarity between the information processing underlying parallel tasks. Translating between species depends not on the superficial similarity of the tasks presented, but rather on the computational similarity of the strategies and mechanisms that underlie those behaviours. Computational validity goes beyond construct validity by directly addressing questions of information processing. Computational validity interacts with circuit validity as computation depends on circuits, but similar computations could be accomplished by different circuits. Because different individuals may use different computations to accomplish a given task, computational validity suggests that behaviour should be understood through the subject's point of view; thus, behaviour should be characterized on an individual level rather than a task level. Tasks can constrain the computational algorithms available to a subject and the observed subtleties of that behaviour can provide information about the computations used by each individual. Computational validity has especially high relevance for the study of psychiatric disorders, given the new views of psychiatry as identifying and mediating information processing dysfunctions that may show high inter-individual variability, as well as for animal models investigating aspects of human psychiatric disorders. This article is part of the theme issue 'Systems neuroscience through the lens of evolutionary theory'.
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Affiliation(s)
- A. David Redish
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Adam Kepecs
- Department of Neuroscience, Washington University in St. Louis, St Louis, MO 63110, USA
- Department of Psychiatry, Washington University in St. Louis, St Louis, MO 63110, USA
| | - Lisa M. Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Olivia L. Calvin
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Nicola M. Grissom
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ann F. Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | | | - Alexander B. Herman
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Suma Jacob
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sisi Ma
- Department of Medicine - Institute for Health Informatics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Iris Vilares
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Cody J. Walters
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alik S. Widge
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jennifer L. Zick
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Anna Zilverstand
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
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19
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Bronstein MV, Kummerfeld E, MacDonald A, Vinogradov S. Willingness to vaccinate against SARS-CoV-2: The role of reasoning biases and conspiracist ideation. Vaccine 2022; 40:213-222. [PMID: 34895784 PMCID: PMC8642163 DOI: 10.1016/j.vaccine.2021.11.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/10/2021] [Accepted: 11/26/2021] [Indexed: 01/01/2023]
Abstract
BACKGR1OUND: Widespread vaccine hesitancy and refusal complicate containment of the SARS-CoV-2 pandemic. Extant research indicates that biased reasoning and conspiracist ideation discourage vaccination. However, causal pathways from these constructs to vaccine hesitancy and refusal remain underspecified, impeding efforts to intervene and increase vaccine uptake. METHOD 554 participants who denied prior SARS-CoV-2 vaccination completed self-report measures of SARS-CoV-2 vaccine intentions, conspiracist ideation, and constructs from the Health Belief Model of medical decision-making (such as perceived vaccine dangerousness) along with tasks measuring reasoning biases (such as those concerning data gathering behavior). Cutting-edge machine learning algorithms (Greedy Fast Causal Inference) and psychometric network analysis were used to elucidate causal pathways to (and from) vaccine intentions. RESULTS Results indicated that a bias toward reduced data gathering during reasoning may cause paranoia, increasing the perceived dangerousness of vaccines and thereby reducing willingness to vaccinate. Existing interventions that target data gathering and paranoia therefore hold promise for encouraging vaccination. Additionally, reduced willingness to vaccinate was identified as a likely cause of belief in conspiracy theories, subverting the common assumption that the opposite causal relation exists. Finally, perceived severity of SARS-CoV-2 infection and perceived vaccine dangerousness (but not effectiveness) were potential direct causes of willingness to vaccinate, providing partial support for the Health Belief Model's applicability to SARS-CoV-2 vaccine decisions. CONCLUSIONS These insights significantly advance our understanding of the underpinnings of vaccine intentions and should scaffold efforts to prepare more effective interventions on hesitancy for deployment during future pandemics.
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Affiliation(s)
- Michael V Bronstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA.
| | - Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, MN, USA
| | - Angus MacDonald
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
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20
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Kambeitz-Ilankovic L, Vinogradov S, Wenzel J, Fisher M, Haas SS, Betz L, Penzel N, Nagarajan S, Koutsouleris N, Subramaniam K. Author Correction: Multivariate pattern analysis of brain structure predicts functional outcome after auditory-based cognitive training interventions. NPJ Schizophr 2021; 7:47. [PMID: 34580304 PMCID: PMC8476539 DOI: 10.1038/s41537-021-00177-w] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Lana Kambeitz-Ilankovic
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Julian Wenzel
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Linda Betz
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Nora Penzel
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Basic Medical Sciences, Neuroscience and Sense Organs-University of Bari Aldo Moro, Bari, Italy
| | - Srikantan Nagarajan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Max Planck Institute of Psychiatry, Munich, Germany
| | - Karuna Subramaniam
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
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21
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Loewy R, Fisher M, Ma S, Carter C, Ragland JD, Niendam TA, Stuart B, Schlosser D, Amirfathi F, Yohannes S, Vinogradov S. Durable Cognitive Gains and Symptom Improvement Are Observed in Individuals With Recent-Onset Schizophrenia 6 Months After a Randomized Trial of Auditory Training Completed Remotely. Schizophr Bull 2021; 48:262-272. [PMID: 34510196 PMCID: PMC8781343 DOI: 10.1093/schbul/sbab102] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Cognitive impairment in schizophrenia predicts functional outcomes and is largely unresponsive to pharmacology or psychotherapy; it is thus a critical unmet treatment need. This article presents the impact of remotely completed, intensive, targeted auditory training (AT) vs control condition computer games (CG) in a double-blind randomized trial in young adults with recent-onset schizophrenia. METHOD Participants (N = 147) were assessed for cognition, symptoms, and functioning at baseline, post-intervention, and at 6-month follow-up. All participants were provided with laptop computers and were instructed to complete 40 hours remotely of training or computer games. An intent-to-treat analysis (N = 145) was performed using linear mixed models with time modeled as a continuous variable. Planned contrasts tested the change from baseline to post-training, baseline to 6-month follow-up, and post-training to 6-month follow-up. RESULTS Global Cognition, which had improved in the AT group relative to the CG group at post-training, showed durable gains at 6-month follow-up in an omnibus group-by-time interaction test (F(1,179) = 4.80, P = .030), as did Problem-Solving (F(1,179) = 5.13, P = .025), and Speed of Processing improved at trend level significance (F(1,170) = 3.80, P = .053). Furthermore, the AT group showed significantly greater improvement than the CG group in positive symptoms (F(1,179) = 4.06, P = .045). CONCLUSIONS These results provide the first evidence of durable cognitive gains and symptom improvement at follow-up of cognitive training (CT) in early schizophrenia completed independently and remotely. While functioning did not show significant improvement, these findings suggest that intensive targeted CT of auditory processing is a promising component of early intervention to promote recovery from psychosis.
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Affiliation(s)
- Rachel Loewy
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA,To whom correspondence should be addressed; 401 Parnassus Ave, Box 0984-PAR, San Francisco, CA 94143-0984, USA; tel: 415-476-7659, fax: 415-502-6361, e-mail:
| | - Melissa Fisher
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Sisi Ma
- School of Medicine, Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, USA,Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Cameron Carter
- Department of Psychiatry, University of California, Davis, Davis, CA, USA
| | - J Daniel Ragland
- Department of Psychiatry, University of California, Davis, Davis, CA, USA
| | - Tara A Niendam
- Department of Psychiatry, University of California, Davis, Davis, CA, USA
| | - Barbara Stuart
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Danielle Schlosser
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA,Verily Life Sciences, South San Francisco, CA, USA
| | - Felix Amirfathi
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Seghel Yohannes
- Department of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Sophia Vinogradov
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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22
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Kambeitz-Ilankovic L, Vinogradov S, Wenzel J, Fisher M, Haas SS, Betz L, Penzel N, Nagarajan S, Koutsouleris N, Subramaniam K. Multivariate pattern analysis of brain structure predicts functional outcome after auditory-based cognitive training interventions. NPJ Schizophr 2021; 7:40. [PMID: 34413310 PMCID: PMC8376975 DOI: 10.1038/s41537-021-00165-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Abstract
Cognitive gains following cognitive training interventions are associated with improved functioning in people with schizophrenia (SCZ). However, considerable inter-individual variability is observed. Here, we evaluate the sensitivity of brain structural features to predict functional response to auditory-based cognitive training (ABCT) at a single-subject level. We employed whole-brain multivariate pattern analysis with support vector machine (SVM) modeling to identify gray matter (GM) patterns that predicted higher vs. lower functioning after 40 h of ABCT at the single-subject level in SCZ patients. The generalization capacity of the SVM model was evaluated by applying the original model through an out-of-sample cross-validation analysis to unseen SCZ patients from an independent validation sample who underwent 50 h of ABCT. The whole-brain GM volume-based pattern classification predicted higher vs. lower functioning at follow-up with a balanced accuracy (BAC) of 69.4% (sensitivity 72.2%, specificity 66.7%) as determined by nested cross-validation. The neuroanatomical model was generalizable to an independent cohort with a BAC of 62.1% (sensitivity 90.9%, specificity 33.3%). In particular, greater baseline GM volumes in regions within superior temporal gyrus, thalamus, anterior cingulate, and cerebellum predicted improved functioning at the single-subject level following ABCT in SCZ participants. The present findings provide a structural MRI fingerprint associated with preserved GM volumes at a single baseline timepoint, which predicted improved functioning following an ABCT intervention, and serve as a model for how to facilitate precision clinical therapies for SCZ based on imaging data, operating at the single-subject level.
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Affiliation(s)
- Lana Kambeitz-Ilankovic
- grid.6190.e0000 0000 8580 3777Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany ,grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Sophia Vinogradov
- grid.17635.360000000419368657Department of Psychiatry, University of Minnesota, Minneapolis, MN USA
| | - Julian Wenzel
- grid.6190.e0000 0000 8580 3777Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany ,grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Melissa Fisher
- grid.17635.360000000419368657Department of Psychiatry, University of Minnesota, Minneapolis, MN USA
| | - Shalaila S. Haas
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Linda Betz
- grid.6190.e0000 0000 8580 3777Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Nora Penzel
- grid.6190.e0000 0000 8580 3777Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany ,grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany ,grid.7644.10000 0001 0120 3326Department of Basic Medical Sciences, Neuroscience and Sense Organs – University of Bari Aldo Moro, Bari, Italy
| | - Srikantan Nagarajan
- grid.266102.10000 0001 2297 6811Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Nikolaos Koutsouleris
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany ,grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Munich, Germany
| | - Karuna Subramaniam
- grid.266102.10000 0001 2297 6811Department of Psychiatry, University of California San Francisco, San Francisco, CA USA
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23
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Jalbrzikowski M, Hayes RA, Wood SJ, Nordholm D, Zhou JH, Fusar-Poli P, Uhlhaas PJ, Takahashi T, Sugranyes G, Kwak YB, Mathalon DH, Katagiri N, Hooker CI, Smigielski L, Colibazzi T, Via E, Tang J, Koike S, Rasser PE, Michel C, Lebedeva I, Hegelstad WTV, de la Fuente-Sandoval C, Waltz JA, Mizrahi R, Corcoran CM, Resch F, Tamnes CK, Haas SS, Lemmers-Jansen ILJ, Agartz I, Allen P, Amminger GP, Andreassen OA, Atkinson K, Bachman P, Baeza I, Baldwin H, Bartholomeusz CF, Borgwardt S, Catalano S, Chee MWL, Chen X, Cho KIK, Cooper RE, Cropley VL, Dolz M, Ebdrup BH, Fortea A, Glenthøj LB, Glenthøj BY, de Haan L, Hamilton HK, Harris MA, Haut KM, He Y, Heekeren K, Heinz A, Hubl D, Hwang WJ, Kaess M, Kasai K, Kim M, Kindler J, Klaunig MJ, Koppel A, Kristensen TD, Kwon JS, Lawrie SM, Lee J, León-Ortiz P, Lin A, Loewy RL, Ma X, McGorry P, McGuire P, Mizuno M, Møller P, Moncada-Habib T, Muñoz-Samons D, Nelson B, Nemoto T, Nordentoft M, Omelchenko MA, Oppedal K, Ouyang L, Pantelis C, Pariente JC, Raghava JM, Reyes-Madrigal F, Roach BJ, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Schall U, Schiffman J, Schlagenhauf F, Schmidt A, Sørensen ME, Suzuki M, Theodoridou A, Tomyshev AS, Tor J, Værnes TG, Velakoulis D, Venegoni GD, Vinogradov S, Wenneberg C, Westlye LT, Yamasue H, Yuan L, Yung AR, van Amelsvoort TAMJ, Turner JA, van Erp TGM, Thompson PM, Hernaus D. Association of Structural Magnetic Resonance Imaging Measures With Psychosis Onset in Individuals at Clinical High Risk for Developing Psychosis: An ENIGMA Working Group Mega-analysis. JAMA Psychiatry 2021; 78:753-766. [PMID: 33950164 PMCID: PMC8100913 DOI: 10.1001/jamapsychiatry.2021.0638] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/04/2021] [Indexed: 01/10/2023]
Abstract
Importance The ENIGMA clinical high risk (CHR) for psychosis initiative, the largest pooled neuroimaging sample of individuals at CHR to date, aims to discover robust neurobiological markers of psychosis risk. Objective To investigate baseline structural neuroimaging differences between individuals at CHR and healthy controls as well as between participants at CHR who later developed a psychotic disorder (CHR-PS+) and those who did not (CHR-PS-). Design, Setting, and Participants In this case-control study, baseline T1-weighted magnetic resonance imaging (MRI) data were pooled from 31 international sites participating in the ENIGMA Clinical High Risk for Psychosis Working Group. CHR status was assessed using the Comprehensive Assessment of At-Risk Mental States or Structured Interview for Prodromal Syndromes. MRI scans were processed using harmonized protocols and analyzed within a mega-analysis and meta-analysis framework from January to October 2020. Main Outcomes and Measures Measures of regional cortical thickness (CT), surface area, and subcortical volumes were extracted from T1-weighted MRI scans. Independent variables were group (CHR group vs control group) and conversion status (CHR-PS+ group vs CHR-PS- group vs control group). Results Of the 3169 included participants, 1428 (45.1%) were female, and the mean (SD; range) age was 21.1 (4.9; 9.5-39.9) years. This study included 1792 individuals at CHR and 1377 healthy controls. Using longitudinal clinical information, 253 in the CHR-PS+ group, 1234 in the CHR-PS- group, and 305 at CHR without follow-up data were identified. Compared with healthy controls, individuals at CHR exhibited widespread lower CT measures (mean [range] Cohen d = -0.13 [-0.17 to -0.09]), but not surface area or subcortical volume. Lower CT measures in the fusiform, superior temporal, and paracentral regions were associated with psychosis conversion (mean Cohen d = -0.22; 95% CI, -0.35 to 0.10). Among healthy controls, compared with those in the CHR-PS+ group, age showed a stronger negative association with left fusiform CT measures (F = 9.8; P < .001; q < .001) and left paracentral CT measures (F = 5.9; P = .005; q = .02). Effect sizes representing lower CT associated with psychosis conversion resembled patterns of CT differences observed in ENIGMA studies of schizophrenia (ρ = 0.35; 95% CI, 0.12 to 0.55; P = .004) and individuals with 22q11.2 microdeletion syndrome and a psychotic disorder diagnosis (ρ = 0.43; 95% CI, 0.20 to 0.61; P = .001). Conclusions and Relevance This study provides evidence for widespread subtle, lower CT measures in individuals at CHR. The pattern of CT measure differences in those in the CHR-PS+ group was similar to those reported in other large-scale investigations of psychosis. Additionally, a subset of these regions displayed abnormal age associations. Widespread disruptions in CT coupled with abnormal age associations in those at CHR may point to disruptions in postnatal brain developmental processes.
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Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca A Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Juan H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paolo Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- EPIC Lab, Department of Psychosis Studies, King's College London, London, United Kingdom
| | - Peter J Uhlhaas
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lukasz Smigielski
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tiziano Colibazzi
- Department of Psychiatry, Columbia University, New York, New York
- New York State Psychiatric Institute, New York
| | - Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Neurobiology of Zhejiang Province, School of Medicine, Zhejiang University Hangzhou, Hangzhou, China
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, Tokyo, Japan
| | - Paul E Rasser
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, Australia
- Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Newcastle, Australia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Wenche Ten Velden Hegelstad
- Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | | | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore
| | - Romina Mizrahi
- Douglas Research Center, Montreal, Quebec, Canada
- McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, New York, New York
| | - Franz Resch
- Clinic for Child and Adolescent Psychiatry, University Hospital of Heidelberg, Heidelberg, Germany
| | - Christian K Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Imke L J Lemmers-Jansen
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - G Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kimberley Atkinson
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Peter Bachman
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Helen Baldwin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
| | - Cali F Bartholomeusz
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Sabrina Catalano
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael W L Chee
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xiaogang Chen
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Kang Ik K Cho
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rebecca E Cooper
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Bjørn H Ebdrup
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Fundació Clínic Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Birte Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centre, Amsterdam, the Netherlands
- Arkin, Amsterdam, the Netherlands
| | - Holly K Hamilton
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Mathew A Harris
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Ying He
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Karsten Heekeren
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy I, LVR-Hospital Cologne, Cologne, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Kiyoto Kasai
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Mallory J Klaunig
- Department of Psychology, University of Maryland, Baltimore County, Baltimore
| | - Alex Koppel
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Tina D Kristensen
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Pablo León-Ortiz
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Xiaoqian Ma
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Patrick McGorry
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Lier, Norway
| | - Tomas Moncada-Habib
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Daniel Muñoz-Samons
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Ketil Oppedal
- Stavanger Medical Imaging Laboratory, Department of Radiology, Stavanger University Hospital, Stavanger, Norway
| | - Lijun Ouyang
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Jose C Pariente
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Jayachandra M Raghava
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Physiology, Nuclear Medicine and PET, Functional Imaging Unit, University of Copenhagen, Glostrup, Denmark
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Brian J Roach
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Jan I Røssberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ulrich Schall
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, Australia
- Priority Research Centre Grow Up Well, The University of Newcastle, Newcastle, Australia
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, Baltimore
- Department of Psychological Science, University of California, Irvine
| | - Florian Schlagenhauf
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
| | - Andre Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Mikkel E Sørensen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Tor G Værnes
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Neuropsychiatry, The Royal Melbourne Hospital, Melbourne, Australia
| | - Gloria D Venegoni
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Christina Wenneberg
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Liu Yuan
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Alison R Yung
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Thérèse A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | | | - Theo G M van Erp
- Center for the Neurobiology of Learning and Memory, Irvine, California
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Los Angeles
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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24
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Ramsay IS, Fryer S, Roach BJ, Boos A, Fisher M, Loewy R, Ford JM, Vinogradov S, Mathalon DH. Response to targeted cognitive training may be neuroprotective in patients with early schizophrenia. Psychiatry Res Neuroimaging 2021; 312:111285. [PMID: 33865147 PMCID: PMC8137670 DOI: 10.1016/j.pscychresns.2021.111285] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/18/2021] [Accepted: 04/06/2021] [Indexed: 01/07/2023]
Abstract
Individuals with schizophrenia exhibit widespread cortical thinning associated with illness severity and deficits in cognition. However, intact cortical thickness (CTh) may serve as a protective factor. The current study sought to examine changes in CTh in response to auditory targeted cognitive training (TCT) in individuals with recent onset schizophrenia. Participants underwent MRI scanning and a cognitive assessment before and after being randomly assigned to 40 h of either TCT (N = 21) or a computer games control condition (CG; N = 22) over 16 weeks. Groups did not differ at baseline on demographic variables or measures of CTh. At the level of group averages, neither group showed significant pre-post changes in CTh in any brain region. However, changes in CTh related to individual differences in treatment outcome, as improved global cognition in the TCT group corresponded to reduced cortical thinning in frontal, temporal, parietal, and occipital lobes. These relationships were not observed in the CG group. The current findings suggest that TCT may be neuroprotective in early schizophrenia, such that individuals who improved in response to training also showed a reduction in cortical thinning that may be otherwise hastened due to age and illness.
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Affiliation(s)
- Ian S Ramsay
- University of Minnesota, Department of Psychiatry and Behavioral Sciences, USA.
| | - Susanna Fryer
- University of California, San Francisco, Department of Psychiatry and Behavioral Science, USA; San Francisco Veterans Affairs Medical Center, USA
| | - Brian J Roach
- University of California, San Francisco, Department of Psychiatry and Behavioral Science, USA; San Francisco Veterans Affairs Medical Center, USA
| | - Alison Boos
- University of California, San Francisco, Department of Psychiatry and Behavioral Science, USA; San Francisco Veterans Affairs Medical Center, USA
| | - Melissa Fisher
- University of Minnesota, Department of Psychiatry and Behavioral Sciences, USA
| | - Rachel Loewy
- University of California, San Francisco, Department of Psychiatry and Behavioral Science, USA; San Francisco Veterans Affairs Medical Center, USA
| | - Judith M Ford
- University of California, San Francisco, Department of Psychiatry and Behavioral Science, USA; San Francisco Veterans Affairs Medical Center, USA
| | - Sophia Vinogradov
- University of Minnesota, Department of Psychiatry and Behavioral Sciences, USA
| | - Daniel H Mathalon
- University of California, San Francisco, Department of Psychiatry and Behavioral Science, USA; San Francisco Veterans Affairs Medical Center, USA
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25
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Haas SS, Hinkley LB, Fisher M, Vinogradov S, Nagarajan S, Subramaniam K. A Neural Biomarker for Hallucinations: Medial Prefrontal Aberrations in Neural Connectivity Predict Self-Agency Deficits and Hallucination Severity in Schizophrenia. J Brain Res 2021; 4:127. [PMID: 38533396 PMCID: PMC10964909] [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] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Prior studies have shown that the medial prefrontal cortex (mPFC) represents one neural substrate that mediates judgments of self-agency (i.e., the awareness that 'I am the originator of my actions'). Patients with schizophrenia (SZ) manifest cardinal self-agency deficits that contribute to debilitating psychotic symptoms (e.g. hallucinations) and distort reality monitoring. This is the first study in which we examine across 2 SZ samples, the mPFC site that underlies self-agency deficits during an explicit reality-monitoring task (i.e., while subjects distinguish self-generated information from externally-derived information) in one SZ sample, and link intrinsic functional connectivity (iFC) during rest within this a priori task-evoked self-agency seed with hallucination symptoms in a different SZ sample. In particular, we examined the iFC between the mPFC site that underlies self-agency deficits with all other brain regions in SZ using resting-state functional magnetic resonance imaging (fMRI). Resting-state fMRI data were collected from 32 SZ and 28 age, gender, and education-matched healthy control (HC) subjects. Functional connectivity maps were computed for each subject and compared between the HC and SZ groups. Within-group and between-group analyses revealed that aberrant iFC in this a priori-defined mPFC 'self-agency seed' predicted hallucination severity. The present findings reveal that the neural aberrations in this mPFC site represents one cardinal biomarker that underlies explicit self-agency deficits during a reality-monitoring task in one SZ sample that generalized to aberrant iFC differences in a different SZ sample and predicted worsening psychotic hallucinatory experiences. This region may represent a key neurobiological target for treatment avenues to improve hallucinatory symptoms.
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Affiliation(s)
- Shalaila S. Haas
- Department of Psychiatry, Icahn School of Medicine Mount Sinai, NY-10029, USA
| | - Leighton B.N. Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA- 94143, USA
| | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, Minneapolis, MN-55414, USA
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, MN-55414, USA
| | - Srikantan Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA- 94143, USA
| | - Karuna Subramaniam
- Department of Psychiatry, University of California, San Francisco, CA-94143, USA
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26
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Capizzi R, Fisher M, Biagianti B, Ghiasi N, Currie A, Fitzpatrick K, Albertini N, Vinogradov S. Testing a Novel Web-Based Neurocognitive Battery in the General Community: Validation and Usability Study. J Med Internet Res 2021; 23:e25082. [PMID: 33955839 PMCID: PMC8138705 DOI: 10.2196/25082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/04/2021] [Accepted: 03/16/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In recent years, there has been increased interest in the development of remote psychological assessments. These platforms increase accessibility and allow clinicians to monitor important health metrics, thereby informing patient-centered treatment. OBJECTIVE In this study, we report the properties and usability of a new web-based neurocognitive assessment battery and present a normative data set for future use. METHODS A total of 781 participants completed a portion of 8 tasks that captured performance in auditory processing, visual-spatial working memory, visual-spatial learning, cognitive flexibility, and emotional processing. A subset of individuals (n=195) completed a 5-question survey measuring the acceptability of the tasks. RESULTS Between 252 and 426 participants completed each task. Younger individuals outperformed their older counterparts in 6 of the 8 tasks. Therefore, central tendency data metrics were presented using 7 different age bins. The broad majority of participants found the tasks interesting and enjoyable and endorsed some interest in playing them at home. Only 1 of 195 individuals endorsed not at all for the statement, "I understood the instructions." Older individuals were less likely to understand the instructions; however, 72% (49/68) of individuals over the age of 60 years still felt that they mostly or very much understood the instructions. CONCLUSIONS Overall, the tasks were found to be widely acceptable to the participants. The use of web-based neurocognitive tasks such as these may increase the ability to deploy precise data-informed interventions to a wider population.
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Affiliation(s)
- Riley Capizzi
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Bruno Biagianti
- Department of Research and Development, Posit Science Corporation, San Francisco, CA, United States
| | - Neelufaer Ghiasi
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Ariel Currie
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Karrie Fitzpatrick
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Nicholas Albertini
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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27
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Zagoloff A, Hong BA, Freese R, Palmer B, Zorumski CF, Vinogradov S, Robiner WN. Academic Psychiatry Department Names: Reflections on Research, Practice, and Education. Acad Psychiatry 2021; 45:164-168. [PMID: 32638245 PMCID: PMC7790880 DOI: 10.1007/s40596-020-01267-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Medical schools' departments reflect changes in health care and medical school organization. The authors reviewed psychiatry department name categories associated with school age, research, and primary care focus. METHODS Department names were identified and categorized for US allopathic and osteopathic medical schools. A multinomial regression model analyzed the relationship between department name category and established year, adjusted for school type. Fisher's exact tests analyzed the relationships between name category and research/primary care foci. RESULTS Among 147 allopathic schools, 52% had departments with names limited to psychiatry, 42% had names with psychiatry plus other terminology, and 5% had no identified psychiatry department. In 34 osteopathic schools, 12% had psychiatry departments, 12% had departments named psychiatry plus other terminology, and 75% had no identified psychiatry department. Age of school was related to departmental name: for a 1-year increase in the school's established year, the odds of having a department name other than psychiatry were 1.02 times the odds (p < 0.001) of having the name psychiatry. Newer schools were less likely to have departments with "psychiatry" in their name. Associations were found between department name and research and primary care rankings. CONCLUSIONS Variability in the names of psychiatry departments in medical schools may suggest changing views within and about academic psychiatry. The limited presence of formal psychiatry departments in newer schools raises questions about psychiatry's impact on educational pathways, the future workforce, and participation in schools' research mission and clinical enterprise.
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Affiliation(s)
| | - Barry A Hong
- Washington University School of Medicine, St. Louis, MO, USA
| | - Rebecca Freese
- Clincal and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Brooke Palmer
- University of Minnesota Medical School, Minneapolis, MN, USA
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28
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Bronstein MV, Vinogradov S. Education alone is insufficient to combat online medical misinformation. EMBO Rep 2021; 22:e52282. [PMID: 33599078 PMCID: PMC7926209 DOI: 10.15252/embr.202052282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 12/23/2020] [Accepted: 01/21/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Michael V Bronstein
- Department of Psychiatry and Behavioral SciencesUniversity of MinnesotaMinneapolisMNUSA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral SciencesUniversity of MinnesotaMinneapolisMNUSA
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29
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Sathianathen NJ, Fan Y, Jarosek SL, Konety I, Weight CJ, Vinogradov S, Konety BR. Disparities in Bladder Cancer Treatment and Survival Amongst Elderly Patients with a Pre-existing Mental Illness. Eur Urol Focus 2020; 6:1180-1187. [DOI: 10.1016/j.euf.2019.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/29/2019] [Accepted: 02/08/2019] [Indexed: 11/12/2022]
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30
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Roisum R, Jenkins D, Fisher M, Currie A, Ma S, Lindgren C, Meyer-Kalos P, Vinogradov S. Targeting Cognition and Motivation in Coordinated Specialty Care for Early Psychosis: A Grant Report. J Psychiatr Brain Sci 2020; 5:e200023. [PMID: 33614975 PMCID: PMC7891550 DOI: 10.20900/jpbs.20200023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this grant report, we describe our project to expand measurement-based psychiatric care across 6 early psychosis treatment teams in Minnesota, and to provide a neuroscience-informed cognitive training and motivation enhancement program for individuals with early psychosis. This project is part of the NIMH Early Psychosis Intervention Network (EPINET) initiative which seeks to link data from treatment centers nationally that offer evidence-based specialty care to persons experiencing early psychosis. Systematic analyses of pooled data collected in EPINET will help inform methods for early psychosis care, psychosis risk factors, and pre-emptive interventions. As part of the national EPINET, our hub (Early Psychosis Intervention-Minnesota, EPI-MINN), will: (1) provide measurement-based care in coordinated specialty care programs for early psychosis, (2) determine whether a structured feedback report provides benefit to stakeholders-service users, family members, and primary clinicians, and (3) explore whether deficits in cognition and motivated behavior-two domains that significantly impact functioning and overall quality of life in early psychosis-can be addressed as key treatment goals by implementing a 12-week mobile intervention. Using a regression discontinuity design, participants will be randomized to the cognitive training and motivational enhancement intervention or to treatment as usual. The intervention consists of neuroscience-informed, computerized auditory and social cognitive training exercises, as well as a mobile app where participants interact with each other and with a motivational coach. Participants will complete assessments at 4 time points: baseline and post-intervention (i.e., at 6 months), and again at 12 and 18 months to test the long-term effects of the intervention. All assessments and interventions in this project can be completed entirely remotely.
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Affiliation(s)
- Rachel Roisum
- Department of Psychiatry & Behavioral Sciences,
University of Minnesota, Minneapolis, MN 55454, USA
| | - Danielle Jenkins
- Department of Psychiatry & Behavioral Sciences,
University of Minnesota, Minneapolis, MN 55454, USA
| | - Melissa Fisher
- Department of Psychiatry & Behavioral Sciences,
University of Minnesota, Minneapolis, MN 55454, USA
| | - Ariel Currie
- Department of Psychiatry & Behavioral Sciences,
University of Minnesota, Minneapolis, MN 55454, USA
| | - Sisi Ma
- Division of General Internal Medicine, University of
Minnesota, Minneapolis, MN 55455, USA
| | - Christopher Lindgren
- Department of Psychiatry & Behavioral Sciences,
University of Minnesota, Minneapolis, MN 55454, USA
| | - Piper Meyer-Kalos
- Department of Psychiatry & Behavioral Sciences,
University of Minnesota, Minneapolis, MN 55454, USA
| | - Sophia Vinogradov
- Department of Psychiatry & Behavioral Sciences,
University of Minnesota, Minneapolis, MN 55454, USA
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31
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Scoriels L, Genaro LT, Mororó LG, Keffer S, Guimarães ALD, Ribeiro PV, Tannos FM, Novaes C, França AI, Goldenstein N, Sahakian BJ, Cavalcanti MT, Fisher M, Vinogradov S, Panizzutti R. Auditory versus visual neuroscience-informed cognitive training in schizophrenia: Effects on cognition, symptoms and quality of life. Schizophr Res 2020; 222:319-326. [PMID: 32448677 PMCID: PMC9703880 DOI: 10.1016/j.schres.2020.05.017] [Citation(s) in RCA: 5] [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: 02/19/2020] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive impairments are related to deficits in primary auditory and visual sensory processes in schizophrenia. These impairments can be remediated by neuroscience-informed computerized cognitive trainings that target auditory and visual processes. However, it is not clear which modality results in greater improvements in cognition, symptoms and quality of life. We aimed to investigate the impact of training auditory versus visual cognitive processes in global cognition in patients with schizophrenia. METHODS Seventy-nine schizophrenia participants were randomly assigned to either 40 h of auditory or visual computerized training. Auditory and visual exercises were chosen to be dynamically equivalent and difficulties increased progressively during the training. We evaluated cognition, symptoms and quality of life before, after 20 h, and after 40 h of training. ClinicalTrials.gov (1R03TW009002-01). RESULTS Participants who received the visual training showed significant improvements in global cognition compared to the auditory training group. The visual training significantly improved attention and reasoning and problem-solving, while the auditory training improved reasoning and problem-solving only. Schizophrenia symptoms improved after training in both groups, whereas quality of life remained unchanged. Interestingly, there was a significant and positive correlation between improvements in attention and symptoms in the visual training group. CONCLUSIONS We conclude that the visual training and the auditory training are differentially efficient at remediating cognitive deficits and symptoms of clinically stable schizophrenia patients. Ongoing follow-up of participants will evaluate the durability of training effects on cognition and symptoms, as well as the potential impact on quality of life over time.
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Affiliation(s)
- Linda Scoriels
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil,Department of Psychiatry, University of Cambridge, United Kingdom
| | - Larissa T. Genaro
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Luana G.C. Mororó
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Stella Keffer
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Anna Luiza D.V. Guimarães
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Paulo V.S. Ribeiro
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Filippe M. Tannos
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Caroline Novaes
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil,Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Aniela I. França
- Faculdade de Letras, Universidade Federal do Rio de Janeiro, Brazil
| | - Nelson Goldenstein
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | | | | | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, United States
| | | | - Rogerio Panizzutti
- Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil.
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32
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Nahum M, Lee H, Fisher M, Green MF, Hooker CI, Ventura J, Jordan JT, Rose A, Kim SJ, Haut KM, Merzenich MM, Vinogradov S. Online Social Cognition Training in Schizophrenia: A Double-Blind, Randomized, Controlled Multi-Site Clinical Trial. Schizophr Bull 2020; 47:108-117. [PMID: 32614046 PMCID: PMC7825077 DOI: 10.1093/schbul/sbaa085] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 12/20/2022]
Abstract
Social cognition (SC), the mental operations underlying social functioning, are impaired in schizophrenia. Their direct link to functional outcome and illness status have made them an important therapeutic target. However, no effective treatment for these deficits is currently applied as a standard of care. To address this need, we have developed SocialVille-an online, plasticity-based training program that targets SC deficits in schizophrenia. Here we report the outcomes of a double-blind, controlled, randomized, multi-site clinical trial of SocialVille. Outpatients with schizophrenia were randomized to complete 40 sessions of either SocialVille (N = 55 completers) or active control (computer games; N = 53 completers) from home. The a priori co-primary outcome measures were a social cognitive composite and a functional capacity outcome (UCSD Performance-based Skills Assessment [UPSA-2]). Secondary outcomes included a virtual functional capacity measure (VRFCAT), social functioning, quality of life, and motivation. Linear mixed models revealed a group × time interaction favoring the treatment group for the social cognitive composite (b = 2.81; P < .001) but not for the UPSA-2 measure. Analysis of secondary outcome measures showed significant group × time effects favoring the treatment group on SC and social functioning, on the virtual functional capacity measure and a motivation subscale, although these latter findings were nonsignificant with FDR correction. These results provide support for the efficacy of a remote, plasticity-based social cognitive training program in improving SC and social functioning in schizophrenia. Such treatments may serve as a cost-effective adjunct to existing psychosocial treatments. Trial Registration: NCT02246426.
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Affiliation(s)
- Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel,Department of Research and Development, Posit Science Inc., San Francisco, CA,To whom correspondence should be addressed; School of Occupational Therapy, Faculty of Medicine, The Hebrew University, PO Box 24026, Mount Scopus, Jerusalem, 91240, Israel; tel: +972-54-732-6655, fax: +972-2-5325345, e-mail:
| | - Hyunkyu Lee
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Michael F Green
- VA Greater Los Angeles, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Joshua T Jordan
- Department of Psychiatry, University of California, San Francisco, CA
| | - Annika Rose
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Sarah-Jane Kim
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Michael M Merzenich
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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33
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Albott CS, Wozniak JR, McGlinch BP, Wall MH, Gold BS, Vinogradov S. Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Health Care Workers During the COVID-19 Pandemic. Anesth Analg 2020; 131:43-54. [PMID: 32345861 PMCID: PMC7199769 DOI: 10.1213/ane.0000000000004912] [Citation(s) in RCA: 233] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The outbreak of the coronavirus disease 2019 (COVID-19) and its rapid global spread have created unprecedented challenges to health care systems. Significant and sustained efforts have focused on mobilization of personal protective equipment, intensive care beds, and medical equipment, while substantially less attention has focused on preserving the psychological health of the medical workforce tasked with addressing the challenges of the pandemic. And yet, similar to battlefield conditions, health care workers are being confronted with ongoing uncertainty about resources, capacities, and risks; as well as exposure to suffering, death, and threats to their own safety. These conditions are engendering high levels of fear and anxiety in the shortterm, and place individuals at risk for persistent stressexposure syndromes, subclinical mental health symptoms, and professional burnout in the longterm. Given the potentially wide-ranging mental health impact of COVID-19, protecting health care workers from adverse psychological effects of the pandemic is critical. Therefore, we present an overview of the potential psychological stress responses to the COVID-19 crisis in medical providers and describe preemptive resilience-promoting strategies at the organizational and personal level. We then describe a rapidly deployable Psychological Resilience Intervention founded on a peersupport model (Battle Buddies) developed by the United States Army. This intervention—the product of a multidisciplinary collaboration between the Departments of Anesthesiology and Psychiatry & Behavioral Sciences at the University of Minnesota Medical Center—also incorporates evidence-informed “stress inoculation” methods developed for managing psychological stress exposure in providers deployed to disasters. Our multilevel, resource-efficient, and scalable approach places 2 key tools directly in the hands of providers: (1) apeersupport Battle Buddy; and (2) adesignated mental health consultant who can facilitate training in stress inoculation methods, provide additional support, or coordinate referral for external professional consultation. In parallel, we have instituted a voluntary research data-collection component that will enable us to evaluate the intervention’s effectiveness while also identifying the most salient resilience factors for future iterations. It is our hope that these elements will provide guidance to other organizations seeking to protect the well-being of their medical workforce during the pandemic. Given the remarkable adaptability of human beings, we believe that, by promoting resilience, our diverse health care workforce can emerge from this monumental challenge with new skills, closer relationships, and greater confidence in the power of community.
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Affiliation(s)
| | | | - Brian P McGlinch
- Anesthesiology, School of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Michael H Wall
- Anesthesiology, School of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Barbara S Gold
- Anesthesiology, School of Medicine, University of Minnesota, Minneapolis, Minnesota
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34
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Kummerfeld E, Ma S, Blackman RK, DeNicola AL, Redish AD, Vinogradov S, Crowe DA, Chafee MV. Cognitive Control Errors in Nonhuman Primates Resembling Those in Schizophrenia Reflect Opposing Effects of NMDA Receptor Blockade on Causal Interactions Between Cells and Circuits in Prefrontal and Parietal Cortices. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 5:705-714. [PMID: 32513554 DOI: 10.1016/j.bpsc.2020.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/28/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The causal biology underlying schizophrenia is not well understood, but it is likely to involve a malfunction in how neurons adjust synaptic connections in response to patterns of activity in networks. We examined statistical dependencies between neural signals at the cell, local circuit, and distributed network levels in prefrontal and parietal cortices of monkeys performing a variant of the AX continuous performance task paradigm. We then quantified changes in the pattern of neural interactions across levels of scale following NMDA receptor (NMDAR) blockade and related these changes to a pattern of cognitive control errors closely matching the performance of patients with schizophrenia. METHODS We recorded the spiking activity of 1762 neurons along with local field potentials at multiple electrode sites in prefrontal and parietal cortices concurrently, and we generated binary time series indicating the presence or absence of spikes in single neurons or local field potential power above or below a threshold. We then applied causal discovery analysis to the time series to detect statistical dependencies between the signals (causal interactions) and compared the pattern of these interactions before and after NMDAR blockade. RESULTS Global blockade of NMDAR produced distinctive and frequently opposite changes in neural interactions at the cell, local circuit, and network levels in prefrontal and parietal cortices. Cognitive control errors were associated with decreased interactions at the cell level and with opposite changes at the network level in prefrontal and parietal cortices. CONCLUSIONS NMDAR synaptic deficits change causal interactions between neural signals at different levels of scale that correlate with schizophrenia-like deficits in cognitive control.
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Affiliation(s)
- Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota
| | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota
| | - Rachael K Blackman
- Medical Scientist Training Program, University of Minnesota, Minneapolis, Minnesota; Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota; Brain Sciences Center, Veterans Administration Medical Center, Minneapolis, Minnesota
| | - Adele L DeNicola
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota; Brain Sciences Center, Veterans Administration Medical Center, Minneapolis, Minnesota
| | - A David Redish
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - David A Crowe
- Department of Biology, Augsburg University, Minneapolis, Minnesota
| | - Matthew V Chafee
- Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota; Brain Sciences Center, Veterans Administration Medical Center, Minneapolis, Minnesota.
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Niles AN, Woolley JD, Tripp P, Pesquita A, Vinogradov S, Neylan TC, O'Donovan A. Randomized Controlled Trial Testing Mobile-Based Attention-Bias Modification for Posttraumatic Stress Using Personalized Word Stimuli. Clin Psychol Sci 2020; 8:756-772. [PMID: 34414018 DOI: 10.1177/2167702620902119] [Citation(s) in RCA: 12] [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: 11/16/2022]
Abstract
Although behavioral therapies are effective for posttraumatic stress disorder (PTSD), access for patients is limited. Attention-bias modification (ABM), a cognitive-training intervention designed to reduce attention bias for threat, can be broadly disseminated using technology. We remotely tested an ABM mobile app for PTSD. Participants (N = 689) were randomly assigned to personalized ABM, nonpersonalized ABM, or placebo training. ABM was a modified dot-probe paradigm delivered daily for 12 sessions. Personalized ABM included words selected using a recommender algorithm. Placebo included only neutral words. Primary outcomes (PTSD and anxiety) and secondary outcomes (depression and PTSD clusters) were collected at baseline, after training, and at 5-week-follow-up. Mechanisms assessed during treatment were attention bias and self-reported threat sensitivity. No group differences emerged on outcomes or attention bias. Nonpersonalized ABM showed greater declines in self-reported threat sensitivity than placebo (p = .044). This study constitutes the largest mobile-based trial of ABM to date. Findings do not support the effectiveness of mobile ABM for PTSD.
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Affiliation(s)
- Andrea N Niles
- San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Psychiatry, University of California, San Francisco
| | - Joshua D Woolley
- San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Psychiatry, University of California, San Francisco
| | - Paige Tripp
- San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Psychiatry, University of California, San Francisco
| | - Ana Pesquita
- San Francisco Veterans Affairs Medical Center, San Francisco, California.,Center for Human Brain Health, University of Birmingham
| | | | - Thomas C Neylan
- San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Psychiatry, University of California, San Francisco
| | - Aoife O'Donovan
- San Francisco Veterans Affairs Medical Center, San Francisco, California.,Department of Psychiatry, University of California, San Francisco
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Herman AB, Brown EG, Dale CL, Hinkley LB, Subramaniam K, Houde JF, Fisher M, Vinogradov S, Nagarajan SS. The Visual Word Form Area compensates for auditory working memory dysfunction in schizophrenia. Sci Rep 2020; 10:8881. [PMID: 32483253 PMCID: PMC7264140 DOI: 10.1038/s41598-020-63962-0] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 03/28/2020] [Indexed: 11/23/2022] Open
Abstract
Auditory working memory impairments feature prominently in schizophrenia. However, the existence of altered and perhaps compensatory neural dynamics, sub-serving auditory working memory, remains largely unexplored. We compared the dynamics of induced high gamma power (iHGP) across cortex in humans during speech-sound working memory in individuals with schizophrenia (SZ) and healthy comparison subjects (HC) using magnetoencephalography (MEG). SZ showed similar task performance to HC while utilizing different brain regions. During encoding of speech sounds, SZ lacked the correlation of iHGP with task performance in posterior superior temporal gyrus (STGp) that was observed in healthy subjects. Instead, SZ recruited the visual word form area (VWFA) during both stimulus encoding and response preparation. Importantly, VWFA activity during encoding correlated with the magnitude of SZ hallucinations, task performance and an independent measure of verbal working memory. These findings suggest that VWFA plasticity is harnessed to compensate for STGp dysfunction in schizophrenia patients with hallucinations.
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Affiliation(s)
- Alexander B Herman
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- UCB-UCSF Graduate Program in Bioengineering, University of California, Berkeley, Berkeley, CA, United States
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Ethan G Brown
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Corby L Dale
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Leighton B Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Karuna Subramaniam
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - John F Houde
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Melissa Fisher
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
- San Francisco Veterans' Affairs Medical Center, San Francisco, CA, United States
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
- San Francisco Veterans' Affairs Medical Center, San Francisco, CA, United States
| | - Srikantan S Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States.
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Ramsay IS, Roach BJ, Fryer S, Fisher M, Loewy R, Ford J, Vinogradov S, Mathalon D. Increased global cognition correlates with increased thalamo-temporal connectivity in response to targeted cognitive training for recent onset schizophrenia. Schizophr Res 2020; 218:131-137. [PMID: 32007346 PMCID: PMC7299776 DOI: 10.1016/j.schres.2020.01.020] [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: 11/12/2019] [Revised: 01/10/2020] [Accepted: 01/19/2020] [Indexed: 10/25/2022]
Abstract
Patients with schizophrenia exhibit disrupted thalamocortical connections that relate to aspects of symptoms and deficits in cognition. Targeted cognitive training (TCT) of the auditory system in schizophrenia has been shown to improve cognition, but its impact on thalamocortical connectivity is not known. Here we examined thalamocortical connections that may be neuroplastic in response to TCT using a region of interest (ROI) approach. Participants were randomly assigned to either 40 h of TCT (N = 24) or an active control condition (CG; N = 20). Participants underwent resting state fMRI and cognitive testing both before and after training. Changes in thalamocortical connectivity were measured in 15 ROIs derived from a previous study comparing a large sample of schizophrenia subjects with healthy controls. A significant group by time interaction was observed in a left superior temporal ROI which was previously found to exhibit thalamocortical hyper-connectivity in patients with schizophrenia. Changes in this ROI reflected thalamic connectivity increases in the TCT group, while the CG group showed decreases. Additionally, the relationship between connectivity change and change in global cognition showed a slope difference between groups, with increases in thalamo-temporal connectivity correlating with improvements in global cognition in TCT. No significant relationships were observed with changes in clinical symptoms or functioning. These findings demonstrate that TCT may influence intrinsic functional connections in young individuals with schizophrenia, such that improvements in cognition correspond to compensatory increases in connectivity in a temporal region previously shown to exhibit thalamic hyper-connectivity.
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Affiliation(s)
| | | | - Susanna Fryer
- University of California, San Francisco Department of Psychiatry,Veterans Affairs Medical Center San Francisco
| | | | - Rachel Loewy
- University of California, San Francisco Department of Psychiatry
| | - Judith Ford
- University of California, San Francisco Department of Psychiatry,Veterans Affairs Medical Center San Francisco
| | | | - Daniel Mathalon
- University of California, San Francisco Department of Psychiatry,Veterans Affairs Medical Center San Francisco
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Puig O, Fisher M, Loewy R, Miley K, Ramsay IS, Carter CS, Ragland JD, Niendam T, Vinogradov S. Early- Versus Adult-Onset Schizophrenia as a Predictor of Response to Neuroscience-Informed Cognitive Training. J Clin Psychiatry 2020; 81:18m12369. [PMID: 32141724 PMCID: PMC8722522 DOI: 10.4088/jcp.18m12369] [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: 05/21/2018] [Accepted: 09/09/2019] [Indexed: 10/24/2022]
Abstract
BACKGROUND Developmental stages characterized by greater neural plasticity might be critical periods during which the effects of cognitive training (CT) could theoretically be maximized. However, experiencing a first episode of schizophrenia during childhood or adolescence (ie, early-onset schizophrenia [EOS]) may reduce the brain's ability to benefit from CT. This study examined the effects of EOS versus onset at > 18 years of age (ie, adult-onset schizophrenia [AOS]) as a predictor of response to CT and the relationship between duration of illness and cognitive improvements. METHODS This study is a secondary analysis of data from 2 randomized trials that examined the cognitive effects of neuroscience-informed auditory training (AT) exercises in 84 outpatients with schizophrenia (26 EOS, 58 AOS, recruited between 2004 and 2014). RESULTS There was a significant effect of time in all cognitive domains (F > 10.22, P < .002). The effect of EOS was significant only for verbal learning and memory (F = 5.79, P = .018). AOS increased the mean change score by 5.70 points in this domain, whereas EOS showed no change (t = -2.280, P = .025). However, the difference between AOS and EOS was no longer statistically significant after control for multiple comparisons. Shorter duration of illness was associated with greater improvement in problem solving in the AOS group (r = -0.27, P = .040). CONCLUSIONS Auditory training is effective in improving cognition in both EOS and AOS. Treatment effects in all cognitive domains were similar, with the exception of verbal learning and memory. This result requires replication. Cognitive training provided earlier in the course of the illness results in greater improvements in executive functions. TRIAL REGISTRATION ClinicalTrials.gov identifiers: NCT00312962, NCT00694889.
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Affiliation(s)
- Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic Barcelona, Villarroel 170, 08036-Spain. .,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Hospital Clínic of Barcelona, CIBERSAM, Barcelona, Spain
| | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Rachel Loewy
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA
| | - Kathleen Miley
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Ian S. Ramsay
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | - Cameron S. Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA
| | - John D. Ragland
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA
| | - Tara Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA
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Miley K, Fisher M, Nahum M, Howard E, Rowlands A, Brandrett B, Woolley J, Hooker CI, Biagianti B, Ramsay I, Vinogradov S. Six month durability of targeted cognitive training supplemented with social cognition exercises in schizophrenia. Schizophr Res Cogn 2020; 20:100171. [PMID: 31908976 PMCID: PMC6938953 DOI: 10.1016/j.scog.2019.100171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 12/15/2022]
Abstract
Background Deficits in cognition, social cognition, and motivation are significant predictors of poor functional outcomes in schizophrenia. Evidence of durable benefit following social cognitive training is limited. We previously reported the effects of 70 h of targeted cognitive training supplemented with social cognitive exercises (TCT + SCT) verses targeted cognitive training alone (TCT). Here, we report the effects six months after training. Methods 111 participants with schizophrenia spectrum disorders were randomly assigned to TCT + SCT or TCT-only. Six months after training, thirty-four subjects (18 TCT + SCT, 16 TCT-only) were assessed on cognition, social cognition, reward processing, symptoms, and functioning. Intent to treat analyses was used to test the durability of gains, and the association of gains with improvements in functioning and reward processing were tested. Results Both groups showed durable improvements in multiple cognitive domains, symptoms, and functional capacity. Gains in global cognition were significantly associated with gains in functional capacity. In the TCT + SCT group, participants showed durable improvements in prosody identification and reward processing, relative to the TCT-only group. Gains in reward processing in the TCT + SCT group were significantly associated with improvements in social functioning. Conclusions Both TCT + SCT and TCT-only result in durable improvements in cognition, symptoms, and functional capacity six months post-intervention. Supplementing TCT with social cognitive training offers greater and enduring benefits in prosody identification and reward processing. These results suggest that novel cognitive training approaches that integrate social cognitive exercises may lead to greater improvements in reward processing and functioning in individuals with schizophrenia.
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Affiliation(s)
- Kathleen Miley
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America.,School of Nursing, University of Minnesota, 308 SE Harvard St., Minneapolis, MN 55454, United States of America
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, PO Box 24026, Mount Scopus, Jerusalem, 94210, Israel
| | - Elizabeth Howard
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Abby Rowlands
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Benjamin Brandrett
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Josh Woolley
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143, United States of America.,Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 400, Chicago, IL, United States of America
| | - Bruno Biagianti
- Posit Science, Inc., 160 Pine St., Suite 200, San Francisco, CA 94111, United States of America
| | - Ian Ramsay
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, United States of America
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40
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Vinogradov S. Standardizing Measures for Early Psychosis: What Are Our Goals? Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 5:4-6. [PMID: 31918891 DOI: 10.1016/j.bpsc.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Sophia Vinogradov
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
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Biagianti B, Fisher M, Loewy R, Brandrett B, Ordorica C, LaCross K, Schermitzler B, McDonald M, Ramsay I, Vinogradov S. Specificity and Durability of Changes in Auditory Processing Efficiency After Targeted Cognitive Training in Individuals With Recent-Onset Psychosis. Front Psychiatry 2020; 11:857. [PMID: 33005156 PMCID: PMC7484996 DOI: 10.3389/fpsyt.2020.00857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/06/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND We previously demonstrated that the high heterogeneity of response to computerized Auditory Training (AT) in psychosis can be ascribed to individual differences in sensory processing efficiency and neural plasticity. In particular, we showed that Auditory Processing Speed (APS) serves as a behavioral measure of target engagement, with faster speed predicting greater transfer effects to untrained cognitive domains. Here, we investigate whether the ability of APS to function as a proxy for target engagement is unique to AT, or if it applies to other training interventions, such as Executive Functioning Training (EFT). Additionally, we examine whether changes in APS are durable after these two forms of training. METHODS One hundred and twenty-five participants with Recent Onset Psychosis (ROP) were randomized to AT (n = 66) and EFT (n = 59), respectively. APS was captured at baseline, after treatment, and at 6-month follow-up. Mixed models repeated measures analysis with restricted maximum likelihood was used to examine whether training condition differentiated APS trajectories. Within-group correlational analyses were used to study the relationship between APS and performance improvements in each of the training exercises. RESULTS The two groups were matched for age, gender, education, and baseline APS. Participants showed high inter-individual variability in APS at each time point. The mixed model showed a significant effect of time (F = 5.99, p = .003) but not a significant group-by-time effect (F = .73, p = .48). This was driven by significant APS improvements AT patients after treatment (d = .75) that were maintained after 6 months (d = .63). Conversely, in EFT patients, APS improvements did not reach statistical significance after treatment (p = .33) or after 6 months (p = .24). In AT patients, baseline APS (but not APS change) highly predicted peak performance for each training exercise (all r's >.42). CONCLUSIONS Participant-specific speed in processing basic auditory stimuli greatly varies in ROP, and strongly influences the magnitude of response to auditory but not executive functioning training. Importantly, enhanced auditory processing efficiency persists 6 months after AT, suggesting the durability of neuroplasticity processes induced by this form of training. Future studies should aim to identify markers of target engagement and durability for cognitive training interventions that target sensory modalities beyond the auditory domain.
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Affiliation(s)
- Bruno Biagianti
- Department of R&D, Posit Science Corporation, San Francisco, CA, United States.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Rachel Loewy
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | | | - Catalina Ordorica
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Kristin LaCross
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Brandon Schermitzler
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Michelle McDonald
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Ian Ramsay
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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Dale CL, Brown EG, Herman AB, Hinkley LBN, Subramaniam K, Fisher M, Vinogradov S, Nagarajan SS. Intervention-specific patterns of cortical function plasticity during auditory encoding in people with schizophrenia. Schizophr Res 2020; 215:241-249. [PMID: 31648842 PMCID: PMC7035971 DOI: 10.1016/j.schres.2019.10.022] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 08/06/2019] [Accepted: 10/03/2019] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a neurocognitive illness characterized by behavioral and neural impairments in both early auditory processing and higher order verbal working memory. Previously we have shown intervention-specific cognitive performance improvements with computerized, targeted training of auditory processing (AT) when compared to a computer games (CG) control intervention that emphasized visual processing. To investigate spatiotemporal changes in patterns of neural activity specific to the AT intervention, the current study used magnetoencephalography (MEG) imaging to derive induced high gamma band oscillations (HGO) during auditory encoding, before and after 50 h (∼10 weeks) of exposure to either the AT or CG intervention. During stimulus encoding, AT intervention-specific changes in high gamma activity occurred in left middle frontal and left middle-superior temporal cortices. In contrast, CG intervention-specific changes were observed in right medial frontal and supramarginal gyri during stimulus encoding, and in bilateral temporal cortices during response preparation. These data reveal that, in schizophrenia, intensive exposure to either training of auditory processing or exposure to visuospatial activities produces significant but complementary patterns of cortical function plasticity within a distributed fronto-temporal network. These results underscore the importance of delineating the specific neuroplastic effects of targeted behavioral interventions to ensure desired neurophysiological changes and avoid unintended consequences on neural system functioning.
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Affiliation(s)
- Corby L Dale
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States; San Francisco Veterans' Affairs Medical Center, United States.
| | - Ethan G Brown
- Weill Cornell Medical College, New York, United States
| | - Alexander B Herman
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States; UCB-UCSF Graduate Program in Bioengineering, University of California, Berkeley, United States; Medical Science Training Program, University of California, San Francisco, United States
| | - Leighton B N Hinkley
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States
| | - Karuna Subramaniam
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States
| | - Melissa Fisher
- San Francisco Veterans' Affairs Medical Center, United States; Department of Psychiatry, University of California, San Francisco, United States
| | - Sophia Vinogradov
- San Francisco Veterans' Affairs Medical Center, United States; Department of Psychiatry, University of California, San Francisco, United States
| | - Srikantan S Nagarajan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, United States; UCB-UCSF Graduate Program in Bioengineering, University of California, Berkeley, United States
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Rowlands A, Fisher M, Mishra J, Nahum M, Brandrett B, Reinke M, Caldwell M, Kiehl KA, Vinogradov S. Cognitive Training for Very High Risk Incarcerated Adolescent Males. Front Psychiatry 2020; 11:225. [PMID: 32351409 PMCID: PMC7175987 DOI: 10.3389/fpsyt.2020.00225] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/09/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Persistent violent and antisocial behavior, as manifested in conduct disorder (CD) traits, are associated with a range of cognitive deficits. Individuals with more severe cognitive deficits are more likely to commit violent crimes. Currently, no treatments target improving cognition in high-risk CD youth. This pilot study tests the feasibility and efficacy of delivering intensive tablet-based cognitive training (CT) to adolescent males incarcerated in a youth maximum-security prison. METHODS Participants were fourteen adolescent males, diagnosed with CD. All participants completed up to 30 h of unsupervised, intensive, adaptive CT exercises that targeted multiple neurocognitive domains, as well as a battery of standardized neurocognitive measures and computerized assessments at baseline and post-training. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE At baseline, participants exhibited significant impairments on neurocognitive measures, relative to age-matched healthy controls. Twelve participants completed training and showed evidence of target engagement, as indexed by improvement in cognitive processing speed. Significant gains were observed in measures of global cognition, with additional gains in cognitive flexibility at trend level significance. Improvements in these measures were positively related to total training time. In summary, both assessments and intervention appear to be feasible, tolerable, and acceptable in incarcerated youth. Intensive CT shows preliminary efficacy in improving neurocognitive performance in key domains, with large effect sizes, and significant performance improvement associations with the time in training.
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Affiliation(s)
- Abby Rowlands
- School of Nursing, University of Maryland Medical Center, Baltimore, MD, United States
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Jyoti Mishra
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Mor Nahum
- Posit Science Inc., San Francisco, CA, United States
| | - Benjamin Brandrett
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Michael Reinke
- Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Michael Caldwell
- Department of Psychology, University of Wisconsin, Madison, WI, United States
| | - Kent A Kiehl
- Department of Psychology, University of New Mexico and Mind Research Network, Albuquerque, NM, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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Ramsay IS, Schallmo MP, Biagianti B, Fisher M, Vinogradov S, Sponheim SR. Deficits in Auditory and Visual Sensory Discrimination Reflect a Genetic Liability for Psychosis and Predict Disruptions in Global Cognitive Functioning. Front Psychiatry 2020; 11:638. [PMID: 32733293 PMCID: PMC7358403 DOI: 10.3389/fpsyt.2020.00638] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/19/2020] [Indexed: 11/29/2022] Open
Abstract
Sensory discrimination thresholds (i.e., the briefest stimulus that can be accurately perceived) can be measured using tablet-based auditory and visual sweep paradigms. These basic sensory functions have been found to be diminished in patients with psychosis. However, the extent to which worse sensory discrimination characterizes genetic liability for psychosis, and whether it is related to clinical symptomatology and community functioning remains unknown. In the current study we compared patients with psychosis (PSY; N=76), their first-degree biological relatives (REL; N=44), and groups of healthy controls (CON; N=13 auditory and visual/N=275 auditory/N=267 visual) on measures of auditory and visual sensory discrimination, and examined relationships with a battery of symptom, cognitive, and functioning measures. Sound sweep thresholds differed among the PSY, REL, and CON groups, driven by higher thresholds in the PSY compared to CON group, with the REL group showing intermediate thresholds. Visual thresholds also differed among the three groups, driven by higher thresholds in the REL versus CON group, and no significant differences between the REL and PSY groups. Across groups and among patients, higher thresholds (poorer discrimination) for both sound and visual sweeps strongly correlated with lower global cognitive scores. We conclude that low-level auditory and visual sensory discrimination deficits in psychosis may reflect genetic liability for psychotic illness. Critically, these deficits relate to global cognitive disruptions that are a hallmark of psychotic illnesses such as schizophrenia.
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Affiliation(s)
- Ian S Ramsay
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Michael-Paul Schallmo
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Bruno Biagianti
- Department of R&D, Posit Science Corporation, San Francisco, CA, United States
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Scott R Sponheim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, United States
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Kambeitz-Ilankovic L, Betz LT, Dominke C, Haas SS, Subramaniam K, Fisher M, Vinogradov S, Koutsouleris N, Kambeitz J. Multi-outcome meta-analysis (MOMA) of cognitive remediation in schizophrenia: Revisiting the relevance of human coaching and elucidating interplay between multiple outcomes. Neurosci Biobehav Rev 2019; 107:828-845. [PMID: 31557548 DOI: 10.1016/j.neubiorev.2019.09.031] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/14/2019] [Accepted: 09/21/2019] [Indexed: 01/02/2023]
Abstract
Cognitive remediation (CR) is nowadays mainly administered in a computerized fashion, yet frequently supplemented by human guidance. The effects of CR on cognitive, functional and clinical outcomes are consistently reported, yet the response is heterogeneous. In order to resolve this heterogeneity, we employed a multi-outcome meta-analytic approach, examined effects of CR on each outcome category separately and estimated directed effects between three outcome categories. We extracted treatment effects from 67 studies that trained patients with schizophrenia (total n = 4067) using either 1) computerized CR modality alone or 2) in combination with supplementary human guidance (SHG). All three outcome domains were significantly improved by CR with small to moderate effect sizes when assessing outcomes across all studies. The comparison between CR administered with SHG revealed largest effects on the cognitive subdomains of working and verbal memory. Structural equation modeling in the single-study data suggests that cognitive gains trigger restoration of psychosocial functioning which in turn facilitates improvement in clinical symptoms.
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Affiliation(s)
- Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
| | - Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Germany
| | - Clara Dominke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Germany
| | - Shalaila S Haas
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, USA
| | | | - Melisa Fisher
- Department of Psychiatry, Medical School, University of Minnesota, USA
| | - Sophia Vinogradov
- Department of Psychiatry, Medical School, University of Minnesota, USA
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Germany
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Biagianti B, Fisher M, Brandrett B, Schlosser D, Loewy R, Nahum M, Vinogradov S. Development and testing of a web-based battery to remotely assess cognitive health in individuals with schizophrenia. Schizophr Res 2019; 208:250-257. [PMID: 30733167 PMCID: PMC6544475 DOI: 10.1016/j.schres.2019.01.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/21/2019] [Accepted: 01/26/2019] [Indexed: 01/06/2023]
Abstract
Cognitive impairment in schizophrenia is often severe, enduring, and contributes significantly to chronic disability. A standardized platform for identifying cognitive impairments and measuring treatment effects in cognition is a critical aspect of comprehensive evaluation and treatment for individuals with schizophrenia. In this project, we developed and tested a suite of ten web-based, neuroscience-informed cognitive assessments that are designed to enable the interpretation of specific deficits that could signal that an individual is experiencing cognitive difficulties. The assessment suite assays speed of processing, sustained attention, executive functioning, learning and socio-affective processing in the auditory and visual modalities. We have obtained data from 283 healthy individuals who were recruited online and 104 individuals with schizophrenia who also completed formal neuropsychological testing. Our data show that the assessments 1) are acceptable and tolerable to users, with successful completion in an average of under 40 min; 2) reliably measure the distinct theoretical cognitive constructs they were designed to assess; 3) can discriminate schizophrenia patients from healthy controls with a fair degree of accuracy (AUROC > 0.70); and 4) have promising construct, convergent, and external validity. Further optimization and validation work is in progress to finalize the evaluation process prior to promoting the dissemination of these assessments in real-world settings.
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Affiliation(s)
| | | | | | - Danielle Schlosser
- Department of Psychiatry, University of California, San Francisco,Verily Life Sciences
| | - Rachel Loewy
- Department of Psychiatry, University of California, San Francisco
| | - Mor Nahum
- School of Occupational Therapy, Hebrew University of Jerusalem
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Panizzutti R, Fisher M, Garrett C, Man WH, Sena W, Madeira C, Vinogradov S. Association between increased serum d-serine and cognitive gains induced by intensive cognitive training in schizophrenia. Schizophr Res 2019; 207:63-69. [PMID: 29699895 PMCID: PMC9770102 DOI: 10.1016/j.schres.2018.04.011] [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: 11/26/2017] [Revised: 04/01/2018] [Accepted: 04/04/2018] [Indexed: 02/04/2023]
Abstract
Neuroscience-guided cognitive training induces significant improvement in cognition in schizophrenia subjects, but the biological mechanisms associated with these changes are unknown. In animals, intensive cognitive activity induces increased brain levels of the NMDA-receptor co-agonist d-serine, a molecular system that plays a role in learning-induced neuroplasticity and that may be hypoactive in schizophrenia. Here, we investigated whether training-induced gains in cognition were associated with increases in serum d-serine in outpatients with schizophrenia. Ninety patients with schizophrenia and 53 healthy controls were assessed on baseline serum d-serine, l-serine, and glycine. Schizophrenia subjects performed neurocognitive tests and were assigned to 50 h of either cognitive training of auditory processing systems (N = 47) or a computer games control condition (N = 43), followed by reassessment of cognition and serum amino acids. At study entry, the mean serum d-serine level was significantly lower in schizophrenia subjects vs. healthy subjects, while the glycine levels were significantly higher. There were no significant changes in these measures at a group level after the intervention. However, in the active training group, increased d-serine was significantly and positively correlated with improvements in global cognition and in Verbal Learning. No such associations were observed in the computer games control subjects, and no such associations were found for glycine. d-Serine may be involved in the neurophysiologic changes induced by cognitive training in schizophrenia. Pharmacologic strategies that target d-serine co-agonism of NMDA-receptor functioning may provide a mechanism for enhancing the behavioral effects of intensive cognitive training.
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Affiliation(s)
- Rogerio Panizzutti
- W.M. Keck Foundation Center for Integrative Neurosciences, 675 Nelson Rising Lane, San Francisco, CA, USA; Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, CCS, Cidade Universitaria, Rio de Janeiro, RJ, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Av. Venceslau Braz, 71, Rio de Janeiro, RJ, Brazil; Department of Psychiatry, UCSF School of Medicine, 982 Mission St, San Francisco, CA, USA.
| | - Melissa Fisher
- Department of Psychiatry, University of Minnesota, United States
| | - Coleman Garrett
- Department of Psychiatry, School of Medicine, University of California, San Francisco, CA
| | - Wai Hong Man
- Department of Psychiatry, School of Medicine, University of California, San Francisco, CA
| | - Walter Sena
- Biomedical Sciences Institute and Psychiatry Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Caroline Madeira
- Biomedical Sciences Institute and Psychiatry Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Affiliation(s)
- Hirofumi Morishita
- Department of Psychiatry, Neuroscience, & Ophthalmology, Icahn School of Medicine at Mount Sinai, USA.
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49
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Affiliation(s)
- Sophia Vinogradov
- From the Department of Psychiatry, University of Minnesota, Minneapolis (Vinogradov)
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50
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Loewy RL, Corey S, Amirfathi F, Dabit S, Fulford D, Pearson R, Hua JPY, Schlosser D, Stuart BK, Mathalon DH, Vinogradov S. Childhood trauma and clinical high risk for psychosis. Schizophr Res 2019; 205:10-14. [PMID: 29779964 PMCID: PMC6939986 DOI: 10.1016/j.schres.2018.05.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [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: 02/03/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/19/2022]
Abstract
As a risk factor for psychosis, childhood trauma rates are elevated in the clinical-high-risk (CHR) syndrome compared to the general population. However, it is unknown whether trauma is typically experienced in childhood or adolescence/young adulthood, whether it occurred prior to CHR syndrome onset, and how severe trauma relates to presenting symptoms. In this study, we examined the relationship of trauma history to symptoms and functioning in individuals diagnosed with the CHR syndrome on the Structured Interview for Psychosis-Risk Syndromes (N = 103). Trauma, defined as meeting the DSM-IV A1 criterion of actual or threatened death or injury, was assessed by semi-structured interview. A large proportion of CHR participants (61%) reported trauma exposure, including interpersonal trauma, trauma prior to CHR onset, and childhood trauma prior to age 12. Those with a trauma history (versus those without trauma) were rated as having more severe perceptual disturbances, general/affective symptoms and more impairment on the Global Assessment of Functioning Scale. The number of traumatic events correlated with more severe ratings in those three domains. Additionally, the number of interpersonal traumas was correlated with ratings of suspiciousness. Trauma was unrelated to specific measures of social and role functioning. A small proportion of CHR participants were diagnosed with formal PTSD (14%), which was unrelated to symptom severity or functioning. Thus, we demonstrate that trauma exposure is often early in life (before age 12), occurs prior to the onset of the CHR syndrome, and is related to both positive and affective symptoms.
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Affiliation(s)
- Rachel L. Loewy
- University of California, San Francisco; Department of Psychiatry; Weill Institute for Neurosciences; 401 Parnassus Ave., Box 0984-PAR, San Francisco, CA 94143-0984
| | - Sarah Corey
- Partners HealthCare, 399 Revolution Drive, Somerville, MA 02145
| | - Felix Amirfathi
- University of California, San Francisco; Department of Psychiatry; Weill Institute for Neurosciences; 401 Parnassus Ave., Box 0984-PAR, San Francisco, CA 94143-0984
| | - Sawsan Dabit
- Posit Science Corporation, 160 Pine Street, Suite 200, San Francisco, CA 94111-5513
| | - Daniel Fulford
- Department of Occupational Therapy and Rehabilitation Sciences and Department of Psychological & Brain Sciences, Boston University; 635 Commonwealth Ave., Boston, MA 02215
| | - Rahel Pearson
- University of Texas at Austin, Institute for Mental Health Research and Department of Psychology, 305 E. 23rd St Stop A9000, Austin, TX 78712
| | - Jessica P. Y. Hua
- University of Missouri; Department of Psychological Sciences; 210 McAlester Hall, Columbia, MO, 65211-2500
| | - Danielle Schlosser
- University of California, San Francisco; Department of Psychiatry; Weill Institute for Neurosciences; 401 Parnassus Ave., Box 0984-PAR, San Francisco, CA 94143-0984,Verily Life Sciences, 269 E Grand Ave, South San Francisco, CA 94080
| | - Barbara K. Stuart
- University of California, San Francisco, Department of Psychiatry, Zuckerberg San Francisco General Hospital and Trauma Center; 1001 Potrero Avenue, Bldg 5, Room 7G42, San Francisco, CA 94110
| | - Daniel H. Mathalon
- University of California, San Francisco; Department of Psychiatry; Weill Institute for Neurosciences; 401 Parnassus Ave., Box 0984-PAR, San Francisco, CA 94143-0984,Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, 94121
| | - Sophia Vinogradov
- Department of Psychiatry, University of Minnesota Medical School; F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454
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