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Matrone M, Kotzalidis GD, Romano A, Bozzao A, Cuomo I, Valente F, Gabaglio C, Lombardozzi G, Trovini G, Amici E, Perrini F, De Persis S, Iasevoli F, De Filippis S, de Bartolomeis A. Treatment-resistant schizophrenia: Addressing white matter integrity, intracortical glutamate levels, clinical and cognitive profiles between early- and adult-onset patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 114:110493. [PMID: 34883221 DOI: 10.1016/j.pnpbp.2021.110493] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 06/16/2021] [Revised: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Treatment-resistance in schizophrenia is 30-40%. Its neurobiology remains unclear; to explore it, we conducted a combined spectrometry/tractography/cognitive battery and psychopathological rating study on patients with treatment-resistant schizophrenia (TRS), dividing the sample into early-onset (N = 21) and adult-onset TRS (N = 20). Previous studies did not differentiate between early- (onset 13-18 years) and adult-onset (>18 years at formal diagnosis of schizophrenia) TRS. METHODS We evaluated cross-sectionally 41 TRS patients (26 male and 15 female) and 20 matched healthy controls (HCs) with psychopathological and cognitive testing prior to participating in brain imaging scanning using magnetic resonance spectroscopy and diffusion tensor imaging to determine the relationship between their symptoms and their glutamate levels and white matter integrity. RESULTS TRS patients scored lower than HCs on all cognitive domains; early-onset patients performed better than adult-onset patients only on the Symbol Coding domain. TRS correlated with symptom severity, especially negative symptoms. Glutamate levels and glutamate/creatine were increased in anterior cingulate cortex. Diffusion tensor imaging showed low fractional anisotropy in TRS patients in specific white matter tracts compared to HCs (bilateral anterior thalamic radiation, cortico-spinal tract, forceps minor, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus, and right uncinate fasciculus). CONCLUSIONS We identified specific magnetic resonance spectroscopy and diffusion tensor imaging alterations in TRS patients. Adult-onset TRS differed little from early-onset TRS on most measures; this points to alterations being present since the outset of schizophrenia and may constitute a biological signature of treatment-resistance.
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Affiliation(s)
- Marta Matrone
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Georgios D Kotzalidis
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Andrea Romano
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Alessandro Bozzao
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
| | - Ilaria Cuomo
- UOC SM I Distretto ASL ROMA 1, C.C. Regina Cœli, Via della Lungara 29, 00165 Rome, Italy.
| | - Francesca Valente
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy; Department of Human Neurosciences, Institute of Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Italy.
| | - Chiara Gabaglio
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Ginevra Lombardozzi
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Giada Trovini
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Emanuela Amici
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Filippo Perrini
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy; UOC SMREE Distretto ASL ROMA 6, TSMREE, Via S. Biagio, 12, 00049, Velletri, Rome, Italy.
| | - Simone De Persis
- UOSD Attività Terapeutiche Riabilitative per i Disturbi da uso di Sostanze e nuove Dipendenze, ASL Rieti, Via Salaria per Roma 36, 02100 Rieti, Italy.
| | - Felice Iasevoli
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.
| | - Sergio De Filippis
- Clinica Neuropsichiatrica Villa von Siebenthal, Department of Neuropsychiatry, Via della Madonnina 1, 00045 Genzano di Roma, RM, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry Laboratory of Molecular and Translational Psychiatry, Unit of Treatment Resistant Psychosis, Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy.
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Lyu H, Jiao J, Feng G, Wang X, Sun B, Zhao Z, Shang D, Pan F, Xu W, Duan J, Zhou Q, Hu S, Xu Y, Xu D, Huang M. Abnormal causal connectivity of left superior temporal gyrus in drug-naïve first- episode adolescent-onset schizophrenia: A resting-state fMRI study. Psychiatry Res Neuroimaging 2021; 315:111330. [PMID: 34280873 DOI: 10.1016/j.pscychresns.2021.111330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/06/2021] [Accepted: 07/02/2021] [Indexed: 12/19/2022]
Abstract
This study aimed to investigate the alterations of causal connectivity between the brain regions in Adolescent-onset schizophrenia (AOS) patients. Thirty-two first-episode drug-naïve AOS patients and 27 healthy controls (HC) were recruited for resting-state functional MRI scanning. The brain region with the between-group difference in regional homogeneity (ReHo) values was chosen as a seed to perform the Granger causality analysis (GCA) and further detect the alterations of causal connectivity in AOS. AOS patients exhibited increased ReHo values in left superior temporal gyrus (STG) compared with HCs. Significantly decreased values of outgoing Granger causality from left STG to right superior frontal gyrus and right angular gyrus were observed in GC mapping for AOS. Significantly stronger causal outflow from left STG to right insula and stronger causal inflow from right middle occipital gyrus (MOG) to left STG were also observed in AOS patients. Based on assessments of the two strengthened causal connectivity of the left STG with insula and MOG, a discriminant model could identify all patients from controls with 94.9% accuracy. This study indicated that alterations of directional connections in left STG may play an important role in the pathogenesis of AOS and serve as potential biomarkers for the disease.
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Affiliation(s)
- Hailong Lyu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jianping Jiao
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Guoxun Feng
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Ningbo Mental Hospital, Ningbo, Zhejiang, China
| | - Xinxin Wang
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bin Sun
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Ningbo Mental Hospital, Ningbo, Zhejiang, China
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China; Columbia University & New York State Psychiatric Institute, New York, United States
| | - Desheng Shang
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Fen Pan
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Weijuan Xu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jinfeng Duan
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | | | - Shaohua Hu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yi Xu
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Dongrong Xu
- Columbia University & New York State Psychiatric Institute, New York, United States.
| | - Manli Huang
- The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China.
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Wang X, Liao W, Han S, Li J, Wang Y, Zhang Y, Zhao J, Chen H. Frequency-specific altered global signal topography in drug-naïve first-episode patients with adolescent-onset schizophrenia. Brain Imaging Behav 2021; 15:1876-1885. [PMID: 33188473 DOI: 10.1007/s11682-020-00381-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Adolescent-onset schizophrenia (AOS) is a severe neuropsychiatric disease associated with frequency-specific abnormalities across distributed neural systems in a slow rhythm. Recently, functional magnetic resonance imaging (fMRI) studies have determined that the global signal. (GS) is an important source of the local neuronal activity in 0.01-0.1 Hz frequency band. However, it remains unknown whether the effects follow a specific spatially preferential pattern in different frequency bands in schizophrenia. To address this issue, resting-state fMRI data from 39 drug-naïve AOS patients and 31 healthy controls (HCs) were used to assess the changes in GS topography patterns in the slow-4 (0.027-0.073 Hz) and slow-5 bands (0.01-0.027 Hz). Results revealed that GS mainly affects the default mode network (DMN) in slow-4 and sensory regions in the slow-5 band respectively, and GS has a stronger driving effect in the slow-5 band. Moreover, significant frequency-by-group interaction was observed in the frontoparietal network. Compared with HCs, patients with AOS exhibited altered GS topography mainly located in the DMN. Our findings demonstrated that the influence of the GS on brain networks altered in a frequency-specific way in schizophrenia.
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Affiliation(s)
- Xiao Wang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Shaoqiang Han
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Yifeng Wang
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China
| | - Yan Zhang
- Key Laboratory for Mental Health of Hunan Province, Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Jingping Zhao
- Mental Health Institute, the Second Xiangya Hospital of Central South University, 139, Middle Renmin Road, Changsha, 410011, Hunan, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, People's Republic of China. .,Radiology department of the First Affiliated Hospital, the Third Military Medical University, Chongqing, 400038, China.
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Zhou M, Zhuo L, Ji R, Gao Y, Yao H, Feng R, Zhang L, Huang G, Huang X. Alterations in functional network centrality in first-episode drug-naïve adolescent-onset schizophrenia. Brain Imaging Behav 2021; 16:316-323. [PMID: 34410608 DOI: 10.1007/s11682-021-00505-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 02/05/2023]
Abstract
Schizophrenia is a disorder resulting from aberrant brain networks and circuits. In the current study, we aimed to investigate specific network alterations in adolescent-onset schizophrenia (AOS) and to help identify the neurophysiological mechanisms of this adolescent disorder. We recruited forty-one subjects, including 20 AOS patients and 21 matched healthy controls (HCs), and we acquired brain images to examine the specific changes in functional network patterns using degree centrality (DC), which quantifies the strength of the local functional connectivity hubs. Whole-brain correlation analysis was applied to assess the relationships between clinical characteristics and DC measurements. The AOS group exhibited increased DC in the right inferior frontal lobe, right fusiform gyrus and right thalamus (p < 0.05, AlphaSim correction). Whole-brain correlation analysis found that the DC value in the right parahippocampus was positively correlated with PANSS-positive symptom scores (r = 0.80); DC in the right superior parietal lobe (SPL) was positively correlated with PANSS-negative symptom scores (r = 0.79); DC in the left precuneus was positively correlated with self-certainty (SC) scores (r = 0.70); and DC in the left medial frontal gyrus (MFG) was negatively correlated with self-reflectiveness (SR) scores (r = 0.69). We conclude that frontoparietal network and cortico-thalamo-cortical pathway disruptions could play key roles in the neurophysiological mechanisms underlying AOS. In AOS patients, the right parahippocampus and SPL are important structures associated with positive and negative symptoms, respectively, and the left precuneus and MFG contribute to deficits in cognitive insights.
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Affiliation(s)
- Ming Zhou
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Lihua Zhuo
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Ruofei Ji
- Department of Psychiatry, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hongchao Yao
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Ruohan Feng
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China.,Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Guoping Huang
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China. .,Department of Psychiatry, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China.
| | - Xiaoqi Huang
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China. .,Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Li D, Zhang F, Wang L, Zhang Y, Yang T, Wang K, Zhu C. Decision making under ambiguity and risk in adolescent-onset schizophrenia. BMC Psychiatry 2021; 21:230. [PMID: 33947364 PMCID: PMC8094464 DOI: 10.1186/s12888-021-03230-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Numerous studies have identified impaired decision making (DM) under both ambiguity and risk in adult patients with schizophrenia. However, the assessment of DM in patients with adolescent-onset schizophrenia (AOS) has been challenging as a result of the instability and heterogeneity of manifestations. The Iowa Gambling Task (IGT) and Game of Dice Task (GDT), which are frequently used to evaluate DM respectively under ambiguity and risk, are sensitive to adolescents and neuropsychiatric patients. Our research intended to examine the performance of DM in a relatively large sample of patients with AOS using the above-mentioned two tasks. We also aimed to take a closer look at the relationship between DM and symptom severity of schizophrenia. METHODS We compared the performance of DM in 71 patients with AOS and 53 well-matched healthy controls using IGT for DM under ambiguity and GDT for DM under risk through net scores, total scores and feedback ration. Neuropsychological tests were conducted in all participants. Clinical symptoms were evaluated by using Positive and Negative Syndrome Scale (PANSS) in 71 patients with AOS. Pearson's correlation revealed the relationship among total score of DM and clinical and neuropsychological data. RESULTS Compared to healthy controls, patients with AOS failed to show learning effect and had a significant difference on the 5th block in IGT and conducted more disadvantageous choices as well as exhibited worse negative feedback rate in GDT. Apart from DM impairment under risk, diminished DM abilities under ambiguity were found related to poor executive function in AOS in the present study. CONCLUSIONS Our findings unveiled the abnormal pattern of DM in AOS, mainly reflected under the risky condition, extending the knowledge on the performance of DM under ambiguity and risk in AOS. Inefficient DM under risk may account for the lagging impulse control and the combined effects of developmental disease. In addition, our study demonstrated that the performance on IGT was related to executive function in AOS.
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Affiliation(s)
- Dandan Li
- grid.412679.f0000 0004 1771 3402Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022 China ,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022 China ,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022 China ,grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022 China
| | - Fengyan Zhang
- grid.33199.310000 0004 0368 7223Children’s Rehabilitation Department, Wuhan Mental Health Center, Wuhan, 430012 China
| | - Lu Wang
- grid.412679.f0000 0004 1771 3402Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022 China
| | - Yifan Zhang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022 China
| | - Tingting Yang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022 China
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China. .,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China. .,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China. .,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China. .,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230022, China.
| | - Chunyan Zhu
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China. .,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China. .,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China.
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Wang X, Liao W, Han S, Lu F, He Z, Yang M, Duan X, Guo J, Zhang Y, Zhao J, Chen H. Abnormal white matter functional connectivity density in antipsychotic-naive adolescents with schizophrenia. Clin Neurophysiol 2021; 132:1025-32. [PMID: 33743297 DOI: 10.1016/j.clinph.2020.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/14/2020] [Accepted: 12/27/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This study aimed to assess the white matter (WM) functional hubs and abnormal functional connectivity pattern in adolescents with schizophrenia (AOS) and to explore the potential mechanisms. METHODS Based on resting-state fMRI data, we measured the WM functional connectivity density (FCD) at local- and long- ranges in 39 AOS and 31 healthy controls (HCs). Group comparison was conducted between the two groups. Spearman rank correlation analysis between the altered WM FCD and clinical PANSS scores was performed. RESULTS In the local scale, the functional hubs of the WM were mainly located in the corona radiata and cerebellum. Compared with HCs, AOS patients exhibited decreased FCD in the superior corona radiata. In the long-range, the functional hubs of the WM were mainly located in the external capsule and pons. AOS patients exhibited increased FCD in the cingulum but decreased FCD in the right dorsal raphe nuclei (DR). Furthermore, the aberrant long-range FCD in the right DR was inversely proportional to the clinical symptoms. CONCLUSION These findings indicated that the pathophysiology of schizophrenia may also lie in WM functional dysconnectivity. SIGNIFICANCE The current results provided initial evidence for the hypothesis of abnormal WM functional connectivity in schizophrenia.
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Zhang S, Yang G, Ou Y, Guo W, Peng Y, Hao K, Zhao J, Yang Y, Li W, Zhang Y, Lv L. Abnormal default-mode network homogeneity and its correlations with neurocognitive deficits in drug-naive first-episode adolescent-onset schizophrenia. Schizophr Res 2020; 215:140-147. [PMID: 31784338 DOI: 10.1016/j.schres.2019.10.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 02/27/2019] [Revised: 07/24/2019] [Accepted: 10/29/2019] [Indexed: 01/15/2023]
Abstract
The default mode network (DMN), is one of the most popularly employed resting-state networks applied in schizophrenia (SCZ) research. However, the homogeneity of this network in adolescent-onset SCZ (AOS) remains unknown. This study aims to use network homogeneity (NH) to explore the functional connectivity in the DMN of AOS patients. Resting-state functional magnetic resonance imaging scans were used to study 48 drug-naïve, first-episode AOS patients and 31 healthy age, gender, and education matched control. An automatic NH approach was employed to analyze the imaging dataset. Our results revealed that the patients had significantly higher NH values in the left medial prefrontal cortex (MPFC), and significantly lower values in the bilateral posterior cingulate cortex/precuneus (PCC/PCu) than those in healthy controls. We performed the receiver operating characteristic curve analysis to show that NH values of the left superior MPFC might be regarded as a potential marker in helping to identify patients. In addition, negative associations were found regarding abnormal values of NH in the left PCC/PCu as well as in the Maze and Stroop color-word tests in patients. The outcomes showed abnormal NH values in the DMN of drug-naïve, first-episode AOS suggesting specific functions of the DMN in the pathophysiology of SCZ.
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Affiliation(s)
- Sen Zhang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, 453002, China
| | - Ge Yang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China
| | - Yangpan Ou
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Wenbin Guo
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Yue Peng
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, 453002, China
| | - Keke Hao
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, 453002, China
| | - Jingping Zhao
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Yongfeng Yang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, 453002, China
| | - Wenqiang Li
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, 453002, China
| | - Yan Zhang
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, 453002, China.
| | - Luxian Lv
- Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453002, China; Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, Xinxiang, 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang, 453002, China.
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Zhao Z, Xu G, Sun B, Li X, Shen Z, Li S, Xu Y, Huang M, Xu D. Altered coupling of spontaneous brain activities and brain temperature in patients with adolescent-onset, first-episode, drug-naïve schizophrenia. Neuroradiology 2019; 61:575-84. [PMID: 30843095 DOI: 10.1007/s00234-019-02181-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE A recent study has reported that schizophrenia patients show an uncoupled association between intraventricular brain temperature (BT) and cerebral blood flow (CBF). CBF has been found to be closely coupled with spontaneous brain activities (SBAs) derived from resting-state BOLD fMRI metrics. Yet, it is unclear so far whether the relationship between the intraventricular BT and the SBAs may change in patients with adolescent-onset schizophrenia (AOS) compared with that in healthy controls (HCs). METHODS The present study recruited 28 first-episode, drug-naïve AOS patients and 22 matched HCs. We measured the temperature of the lateral ventricles (LV) using diffusion-weighted imaging thermometry and measured SBAs using both regional homogeneity and amplitude of low-frequency fluctuation methods. A nonparametric Wilcoxon rank sum test was used to detect the difference in intraventricular BT between AOS patients and HCs with LV volume, age, and sex as covariates. We also evaluated the relationship between the intraventricular BT and the SBAs using partial correlation analysis controlling for LV volume, age, and sex. RESULTS We found that HCs showed a significant negative correlation between the intraventricular BT and the local SBAs in the bilateral putamina and left superior temporal gyrus, while such a correlation was absent in AOS patients. Additionally, no significant difference between the two groups was found in the intraventricular BT. CONCLUSION These findings suggest that AOS patients may experience an uncoupling between intraventricular BT and SBAs in several schizophrenia-related brain areas, which may be associated with the altered relationships among intraventricular BT, CBF, and metabolism.
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Zhang L, Wang X, Zhang Y, Yang YF, Li WW, Li BL, Zhang D, Lü LX. [Cerebral grey matter changes of pre- and post-treatment in first-episode drug-naive adolescents schizophrenia]. Zhonghua Yi Xue Za Zhi 2018; 98:2968-72. [PMID: 30392249 DOI: 10.3760/cma.j.issn.0376-2491.2018.37.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the gray matter(GM) volume and the change of GM volume after antipsychotic treatment for 8 weeks in first-episode drug-naive adolescents with schizophrenia. Methods: T1-weighted brain MRIs were obtained on a 3T scanner in 35 controls and 35 subjects with adolescents schizophrenia who were admitted to the Second Affiliated Hospital of Xinxiang Medical College from April 2015 to June 2016 and not given antipsychotic medication, the schizophrenia patients received second scan after 8 weeks of antipsychotic treatment. Positive and negative syndrome scale (PANSS) assessments were performed in patients pre- and post-treatment; voxel-based morphometry (VBM) was used to analyze changes of GM volume and the correlation between the baseline GM volume and the PANSS scores was further analyzed. Results: GM volumes in the left frontal gyrus (MIN(x, y, z): -13.5, 36, 46.5), left superior parietal lobule (MIN(x, y, z): -52.5, -42, 52.5), left inferior parietal lobule (MIN(x, y, z): -31.5, -45, 69) and left central anterior (MIN(x, y, z): 9, 21, 61.5) were significantly smaller than those in the normal control group (t=-4.384 0, -4.556 2, -6.430 9, -4.313 9 respectively, P<0.001); after treatment for 8 weeks PANSS scores were significantly lower than those of baseline (P<0.001), however, there was no significant difference in regional GM volume between the pre-and post-treatment (P>0.05) and no significant correlation was found between GM volume and PANSS scores. Conclusion: There are local GM volume reductions in subjects with adolescents schizophrenia and these regions may be independent to mental symptoms of patients.
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Wang S, Zhan Y, Zhang Y, Lyu L, Lyu H, Wang G, Wu R, Zhao J, Guo W. Abnormal long- and short-range functional connectivity in adolescent-onset schizophrenia patients: A resting-state fMRI study. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:445-451. [PMID: 28823850 DOI: 10.1016/j.pnpbp.2017.08.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 12/27/2016] [Revised: 08/02/2017] [Accepted: 08/15/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Human brain is a topologically complex network embedded in anatomical space, and anatomical distance may affect functional connectivity (FC) in schizophrenia. However, little is known if and how this effect occurs in adolescent-onset schizophrenia (AOS). METHODS We explored long- and short-range FC through resting-state functional magnetic resonance imaging in 48 first-episode, drug-naive AOS patients and 31 healthy controls, and we examined if these abnormalities could be utilized to separate patients from controls using receiver operating characteristic curves and support vector machines (SVM). RESULTS Patients had increased long-range positive FC (lpFC) and short-range positive FC (spFC) in the right middle frontal gyrus and right superior medial prefrontal cortex within the anterior default mode network (DMN), decreased lpFC and spFC in several regions of the posterior DMN, and decreased lpFC within the important hubs of salience network (SN). The decreased lpFC in the left superior temporal gyrus was positively correlated with cognitive impairment. We found that SVM has high accuracy (up to 92.4%) in classifying patients and control. CONCLUSION Disrupted anatomical distance would underlie network-level dysconnectivity, highlighting the importance of the DMN and SN in the neurodevelopment of schizophrenia. Abnormalities of long- and short-range FC in brain regions could discriminate patients from controls with high accuracy.
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Affiliation(s)
- Shuai Wang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Health Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Yajing Zhan
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yan Zhang
- Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Luxian Lyu
- Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Hailong Lyu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Health Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Guodong Wang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Health Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Renrong Wu
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Health Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Health Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China; Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
| | - Wenbin Guo
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Health Disorders, National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China.
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Liu Y, Zhang Y, Lv L, Wu R, Zhao J, Guo W. Abnormal neural activity as a potential biomarker for drug-naive first-episode adolescent-onset schizophrenia with coherence regional homogeneity and support vector machine analyses. Schizophr Res 2018; 192:408-15. [PMID: 28476336 DOI: 10.1016/j.schres.2017.04.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 04/12/2017] [Accepted: 04/14/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with adolescent-onset schizophrenia (AOS) hold the same but severe form of symptoms with adult-onset schizophrenia, and with worse outcome and poor treatment response to antipsychotics. Several dominant brain regions of schizophrenia patients show significantly abnormal structural and functional connectivity during resting-state scans. However, coherence regional homogeneity (Cohe-ReHo) in drug-naive first-episode patients with AOS remains unclear. METHOD A total of 48 drug-naive first-episode AOS outpatients and 31 healthy controls underwent resting-state functional magnetic resonance scans. Cohe-ReHo and support vector machine analyses were used to analyze the data. RESULTS Compared with the healthy controls, the AOS group showed significantly decreased Cohe-ReHo values distributed over brain regions, including the left postcentral gyrus, left superior temporal gyrus, left paracentral lobule, right precentral gyrus, right inferior parietal lobule (IPL), right middle frontal gyrus, and bilateral precuneus. No region with increased Cohe-ReHo values was observed in the AOS group compared with healthy controls. In addition, the right IPL was correlated with fluency (r=-0.324, p=0.030). However, the correlation was not significant after the Bonferroni correction at p<0.0083 (0.05/6). A combination of the Cohe-ReHo values in the bilateral precuneus and right IPL discriminated the patients from controls with the sensitivity, specificity, and accuracy of 91.67%, 87.10%, and 89.87%, respectively. CONCLUSION Our findings suggested that the AOS patients exhibited diminished Cohe-ReHo values in some regions within the DMN network and sensorimotor network. The abnormalities in particular brain regions (bilateral precuneus and right IPL) may serve as potential biomarkers for AOS.
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Wang S, Zhang Y, Lv L, Wu R, Fan X, Zhao J, Guo W. Abnormal regional homogeneity as a potential imaging biomarker for adolescent-onset schizophrenia: A resting-state fMRI study and support vector machine analysis. Schizophr Res 2018; 192:179-184. [PMID: 28587813 DOI: 10.1016/j.schres.2017.05.038] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [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: 07/13/2016] [Revised: 05/04/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Structural and functional abnormalities have been reported in the brain of patients with adolescent-onset schizophrenia (AOS). The brain regional functional synchronization in patients with AOS remains unclear. METHODS We analyzed resting-state functional magnetic resonance scans in 48 drug-naive patients with AOS and 31 healthy controls by using regional homogeneity (ReHo), a measurement that reflects brain local functional connectivity or synchronization and indicates regional integration of information processing. Then, receiver operating characteristic curves and support vector machines were used to evaluate the effect of abnormal regional homogeneity in differentiating patients from controls. RESULTS Patients with AOS showed significantly increased ReHo values in the bilateral superior medial prefrontal cortex (MPFC) and significantly decreased ReHo values in the left superior temporal gyrus (STG), right precentral lobule, right inferior parietal lobule (IPL), and left paracentral lobule when compared with controls. A combination of the ReHo values in bilateral superior MPFC, left STG, and right IPL was able to discriminate patients from controls with the sensitivity of 88.24%, specificity of 91.89%, and accuracy of 90.14%. CONCLUSION The brain regional functional synchronization abnormalities exist in drug-naive patients with AOS. A combination of ReHo values in these abnormal regions might serve as potential imaging biomarker to identify patients with AOS.
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Affiliation(s)
- Shuai Wang
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center on Mental Disorders, Changsha, China; National Technology Institute on Mental Disorders, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Yan Zhang
- Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Luxian Lv
- Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Renrong Wu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center on Mental Disorders, Changsha, China; National Technology Institute on Mental Disorders, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xiaoduo Fan
- UMass Memorial Medical Center, UMass Medical School, Worcester, USA
| | - Jingping Zhao
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center on Mental Disorders, Changsha, China; National Technology Institute on Mental Disorders, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China; Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
| | - Wenbin Guo
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center on Mental Disorders, Changsha, China; National Technology Institute on Mental Disorders, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China.
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Wang S, Zhan Y, Zhang Y, Lv L, Wu R, Zhao J, Guo W. Abnormal functional connectivity strength in patients with adolescent-onset schizophrenia: a resting-state fMRI study. Eur Child Adolesc Psychiatry 2017; 26:839-45. [PMID: 28185094 DOI: 10.1007/s00787-017-0958-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/31/2017] [Indexed: 01/12/2023]
Abstract
Structural and functional abnormalities were reported in the brain of patients with adolescent-onset schizophrenia (AOS). However, evidence of abnormal functional connectivity of the brain in AOS patients is limited. Thus, we analyzed the resting-state functional magnetic resonance scans of 48 drug-naive AOS patients and 31 healthy controls to determine their functional connectivity strength (FCS) and examined if FCS abnormalities were correlated with clinical characteristics. Compared with healthy controls, AOS patients showed significantly increased FCS in the left cerebellum VI and right inferior frontal gyrus/insula. A positive correlation was observed between FCS values in the right inferior frontal gyrus/insula and general psychopathology scores of positive and negative syndrome scale. Results suggest that functional connectivity pattern is disrupted in drug-naive AOS patients. The FCS values in this abnormal region have potential for evaluating the disease severity.
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