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Jia Y, Kudo K, Jariwala N, Tarapore P, Nagarajan S, Subramaniam K. Causal role of medial superior frontal cortex on enhancing neural information flow and self-agency judgments in the self-agency network. Neuroimage 2025; 313:121245. [PMID: 40306346 DOI: 10.1016/j.neuroimage.2025.121245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2025] [Revised: 03/28/2025] [Accepted: 04/28/2025] [Indexed: 05/02/2025] Open
Abstract
Self-agency is being aware of oneself as the agent of one's thoughts and actions. Self-agency is necessary for successful interactions with the outside world (reality-monitoring). Prior research has shown that the medial superior prefrontal gyri (mPFC/SFG) may represent one neural correlate underlying self-agency judgments. However, the causal relationship remains unknown. Here, we applied high-frequency 10 Hz repetitive transcranial magnetic stimulation (rTMS) to modulate the excitability of the mPFC/SFG site that we have previously shown to mediate self-agency. For the first time, we delineate causal neural mechanisms, revealing precisely how rTMS modulates SFG excitability and impacts directional neural information flow in the self-agency network by implementing innovative magnetoencephalography (MEG) phase-transfer entropy (PTE) metrics, measured from pre-to-post rTMS. We found that, compared to control rTMS, enhancing SFG excitability by rTMS induced significant increases in information flow between SFG and specific cingulate and paracentral regions in the self-agency network in delta-theta, alpha, and gamma bands, which predicted improved self-agency judgments. This is the first multimodal imaging study in which we implement MEG PTE metrics of 5D imaging of space, frequency and time, to provide cutting-edge analyses of the causal neural mechanisms of how rTMS enhances SFG excitability and improves neural information flow between distinct regions in the self-agency network to potentiate improved self-agency judgments. Our findings provide a novel perspective for investigating causal neural mechanisms underlying self-agency and create a path towards developing novel neuromodulation interventions to improve self-agency that will be particularly useful for patients with psychosis who exhibit severe impairments in self-agency.
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Affiliation(s)
- Yingxin Jia
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Kiwamu Kudo
- Medical Imaging Center, Ricoh Company Ltd., Kanazawa, Japan
| | - Namasvi Jariwala
- Department of Clinical Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Phiroz Tarapore
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Srikantan Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Karuna Subramaniam
- Department of Psychiatry, University of California, San Francisco, CA, USA.
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Pines AR, Frandsen SB, Drew W, Meyer GM, Howard C, Palm ST, Schaper FLWVJ, Lin C, Butenko K, Ferguson MA, Friedrich MU, Grafman JH, Kappel AD, Neudorfer C, Rost NS, Sanderson LL, Taylor JJ, Wu O, Kletenik I, Vogel JW, Cohen AL, Horn A, Fox MD, Silbersweig D, Siddiqi SH. Mapping Lesions That Cause Psychosis to a Human Brain Circuit and Proposed Stimulation Target. JAMA Psychiatry 2025; 82:368-378. [PMID: 39937525 PMCID: PMC11822627 DOI: 10.1001/jamapsychiatry.2024.4534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 11/19/2024] [Indexed: 02/13/2025]
Abstract
Importance Identifying anatomy causally involved in psychosis could inform therapeutic neuromodulation targets for schizophrenia. Objective To assess whether lesions that cause secondary psychosis have functional connections to a common brain circuit. Design, Setting, and Participants This case-control study mapped functional connections of published cases of lesions causing secondary psychosis compared with control lesions unassociated with psychosis. Published cases of lesion-induced psychosis were analyzed in a computational laboratory. Participants had documented brain lesions associated with new-onset psychotic symptoms without a history of psychosis. Control cases included 1156 patients with lesions not associated with psychosis. Generalizability across lesional datasets was assessed using an independent cohort of 181 patients with brain lesions who subsequently underwent neurobehavioral testing. Data were analyzed from June 2022 to April 2024. Exposures Lesions causing secondary psychosis. Main Outcomes and Measures Psychosis or no psychosis. Results A total of 153 lesions from published cases were determined to be causal of psychosis, 42 of which were described as schizophrenia or schizophrenia-like (71 [46%] patients were male, 82 [54%] female; mean [SD] age, 50.0 [20.8] years). Lesions that caused secondary psychosis mapped to a common brain circuit defined by functional connectivity to the posterior subiculum of the hippocampus (84% functional overlap, family-wise error [FWE] rate corrected P < 5 × 10-5). At a lower statistical threshold (>75% overlap, FWE-corrected P < 5 × 10-4), this circuit included the ventral tegmental area, retrosplenial cortex, lobule IX and dentate nucleus of the cerebellum, and the mediodorsal and midline nuclei of the thalamus. This circuit was consistent when derived from schizophrenia-like cases (spatial r = 0.98). We repeated these analyses after excluding lesions intersecting the hippocampus (n = 47) and found a consistent functional connectivity profile (spatial r = 0.98) with the posterior subiculum remaining the center of connectivity (>75% overlap, FWE-corrected P < 5 × 10-5), demonstrating a circuit-level effect. In an independent observational cohort of patients with penetrating head trauma (n = 181), lesions associated with symptoms of psychosis exhibited significantly similar connectivity profiles to the lesion-derived psychosis circuit (suspiciousness, P = .03; unusual thought content, P = .046). Voxels in the rostromedial prefrontal cortex are highly correlated with this psychosis circuit (spatial r = 0.82), suggesting the rostromedial prefrontal cortex as a promising transcranial magnetic stimulation target for psychosis. Conclusions and Relevance Lesions that cause secondary psychosis affect a common brain circuit in the hippocampus. These results can help inform therapeutic neuromodulation targeting.
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Affiliation(s)
- Andrew R. Pines
- Department of Psychiatry, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Summer B. Frandsen
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - William Drew
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Garance M. Meyer
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Calvin Howard
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stephan T. Palm
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Frederic L. W. V. J. Schaper
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christopher Lin
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Konstantin Butenko
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael A. Ferguson
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maximilian U. Friedrich
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jordan H. Grafman
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Shirley Ryan AbilityLab, Chicago, Illinois
| | - Ari D. Kappel
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurosurgery, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Clemens Neudorfer
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston
- Brain Modulation Lab, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Natalia S. Rost
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lauren L. Sanderson
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joseph J. Taylor
- Department of Psychiatry, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ona Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Isaiah Kletenik
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jacob W. Vogel
- SciLifeLab, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Alexander L. Cohen
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
- Computational Radiology Laboratory, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andreas Horn
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael D. Fox
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - David Silbersweig
- Department of Psychiatry, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shan H. Siddiqi
- Department of Psychiatry, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Brain Circuit Therapeutics, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Kirby ED, Beyst B, Beyst J, Brodie SM, D’Arcy RCN. A retrospective, observational study of real-world clinical data from the Cognitive Function Development Therapy program. Front Hum Neurosci 2024; 18:1508815. [PMID: 39743989 PMCID: PMC11688245 DOI: 10.3389/fnhum.2024.1508815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Accepted: 12/03/2024] [Indexed: 01/04/2025] Open
Abstract
Introduction Cognitive deficits are common in psychiatric and mental health disorders, making the assessment of cognitive function in mental health treatment an important area of research. Cognitive Function Development Therapy (CFDT) is a novel therapeutic modality designed to enhance cognitive function and regulate the autonomic nervous system through targeted exercises and activities focused on attention networks and memory systems. The therapy is tracked and based on Primary Cognitive Function (PCF) scores. Methods This retrospective, observational study analyzed real world data from 183 children and adults undergoing CFDT to evaluate changes in cognition over time, incorporating both cognitive performance measures and an exploratory analysis of neurophysiological function. Objective neurophysiological measures in the form of the brain vital signs framework, based in event-related potentials (ERPs), were measured in a small subset of clients to explore the frameworks use in CFDT. Results Our findings indicate that CFDT holds promise for improving cognitive performance, as evidenced by increased PCF scores at the group level compared to pre-treatment levels [F (5, 173) = 7.087, p < 0.001, ηp 2 = 0.170]. Additionally, a weak effect of age [Spearman's Rho range: -0.301 to -0.340, p < 0.001] was found to influence the degree of cognitive improvement, suggesting the importance of early intervention for maximizing cognitive gains. The exploratory analysis suggested that CFDT may affect neurophysiological measures of information processing, particularly in basic attention, as reflected in increased amplitude in P300 measures. Discussion While these initial findings are encouraging, caution is warranted due to the retrospective nature of the study, though overall, the results suggest a positive impact of CFDT on cognitive function.
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Affiliation(s)
- Eric D. Kirby
- BrainNet, Health and Technology District, Surrey, BC, Canada
- Faculty of Individualized Interdisciplinary Studies, Simon Fraser University, Burnaby, BC, Canada
- Faculty of Science, Simon Fraser University, Burnaby, BC, Canada
- Centre for Neurology Studies, HealthTech Connex, Metro Vancouver, BC, Canada
| | - Brian Beyst
- Cognitive Function Development Institute, Prescott Valley, AZ, United States
| | - Jen Beyst
- Cognitive Function Development Institute, Prescott Valley, AZ, United States
| | - Sonia M. Brodie
- Centre for Neurology Studies, HealthTech Connex, Metro Vancouver, BC, Canada
| | - Ryan C. N. D’Arcy
- BrainNet, Health and Technology District, Surrey, BC, Canada
- Centre for Neurology Studies, HealthTech Connex, Metro Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada
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Li Q, Li M, Wu C. Methods and measures of source monitoring in children: A scoping review. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2024. [PMID: 39315748 DOI: 10.1111/bjdp.12523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 09/04/2024] [Indexed: 09/25/2024]
Abstract
Source monitoring (SM) refers to attributing sources of information. There are various methods for measuring SM in children. We searched the PubMed, PsycINFO, Embase, Web of Science and Cochrane Library databases from their inception to February 24, 2023, to summarize the methods and measures of SM in children, identifying 141 studies. The procedure for the SM tasks encompassed encoding, interval and testing. The encoding tasks were classified into ground-based activities (n = 67), computer-based experiments (n = 42) and mixed methods (n = 34). The testing approaches were categorized into old/new recognition and source discrimination, n-alternative forced-choice, yes/no questions and recall/direct questions. Among 10 commonly used indicators, source-correct, source-incorrect, discrimination score and source accuracy were recommended to present the SM function. We also discussed the advantages and disadvantages of different SM methods in children, providing a reference for researchers to design and select SM measurements that meet their research objectives.
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Affiliation(s)
- Qiuhong Li
- School of Nursing, Peking University, Haidian District, Beijing, China
| | - Mengyuan Li
- School of Nursing, Peking University, Haidian District, Beijing, China
| | - Chao Wu
- School of Nursing, Peking University, Haidian District, Beijing, China
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Liu L, Wang H, Xing Y, Zhang Z, Zhang Q, Dong M, Ma Z, Cai L, Wang X, Tang Y. Dose-response relationship between computerized cognitive training and cognitive improvement. NPJ Digit Med 2024; 7:214. [PMID: 39147783 PMCID: PMC11327304 DOI: 10.1038/s41746-024-01210-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024] Open
Abstract
Although computerized cognitive training (CCT) is an effective digital intervention for cognitive impairment, its dose-response relationship is understudied. This retrospective cohort study explores the association between training dose and cognitive improvement to find the optimal CCT dose. From 2017 to 2022, 8,709 participants with subjective cognitive decline, mild cognitive impairment, and mild dementia were analyzed. CCT exposure varied in daily dose and frequency, with cognitive improvement measured weekly using Cognitive Index. A mixed-effects model revealed significant Cognitive Index increases across most dose groups before reaching the optimal dose. For participants under 60 years, the optimal dose was 25 to <30 min per day for 6 days a week. For those 60 years or older, it was 50 to <55 min per day for 6 days a week. These findings highlight a dose-dependent effect in CCT, suggesting age-specific optimal dosing for cognitive improvement.
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Affiliation(s)
- Liyang Liu
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Haibo Wang
- Clinical Research Institute, Institute of Advanced Clinical Medicine, Peking University, 100191, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, 38 Xueyuan St, Haidian district, 100191, Beijing, China
| | - Yi Xing
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China
| | - Ziheng Zhang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Qingge Zhang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Ming Dong
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Zhujiang Ma
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Longjun Cai
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Xiaoyi Wang
- Beijing Wispirit Technology Co., Ltd., Beijing, China
| | - Yi Tang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China.
- Neurodegenerative Laboratory of Ministry of Education of the People's Republic of China, Beijing, China.
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Markiewicz R, Markiewicz-Gospodarek A, Trubalski M, Łoza B. Neurocognitive, Clinical and Reelin Activity in Rehabilitation Using Neurofeedback Therapy in Patients with Schizophrenia. J Clin Med 2024; 13:4035. [PMID: 39064075 PMCID: PMC11277514 DOI: 10.3390/jcm13144035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/01/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Introduction: Reelin is a neuropeptide responsible for the migration and positioning of pyramidal neurons, interneurons, and Purkinje cells. In adulthood, it still supports neuroplasticity, especially dendritic spines formation and glutamatergic neurotransmission. Genetic studies have confirmed the involvement of reelin system failure in the etiopathogenesis of mental diseases, including schizophrenia. Given the role of reelin in brain cytoarchitectonics and the regularly observed reduction in its activity in prefrontal areas in cases of schizophrenia, dysfunction of the reelin pathway fits the neurodevelopmental hypothesis of schizophrenia, both as a biochemical predisposition and/or the ultimate trigger of psychosis and as a biosocial factor determining the clinical course, and finally, as a potential target for disease monitoring and treatment. Aim: The purpose of this study was to examine associations of the reelin blood level with clinical and neurocognitive parameters during an intensive, structured neurofeedback therapy of patients with schizophrenia. Methods: Thirty-seven male patients with paranoid schizophrenia were randomly divided into two groups: a group with 3-month neurofeedback as an add-on to ongoing antipsychotic treatment (NF, N18), and a control group with standard social support and antipsychotic treatment (CON, N19). The reelin serum concentration, clinical and neurocognitive tests were compared between the groups. Results: After 3-month trial (T2), the reelin serum level increased in the NF group vs. the CON group. The negative and general symptoms of PANSS (Positive and Negative Syndrome Scale) were reduced significantly more in the NF group at T2, and the d2 (d2 Sustained Attention Test) and BCIS (Beck Cognitive Insight Scale) scores improved only in the NF group. The AIS scores improved more dynamically in the NF group, but not enough to differentiate them from the CON group at T2. Conclusions: The clinical and neurocognitive improvement within the 3-month NF add-on therapy trial was associated with a significant increase of reelin serum level in schizophrenia patients.
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Affiliation(s)
- Renata Markiewicz
- Occupational Therapy Laboratory, Medical University of Lublin, 7 Chodźki St., 20-093 Lublin, Poland;
| | | | - Mateusz Trubalski
- Student Scientific Association at the Department of Normal, Clinical and Imaging Anatomy, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Bartosz Łoza
- Department of Psychiatry, Medical University of Warsaw, 02-091 Warsaw, Poland;
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Singh B, Wang Z, Madiah LM, Gatti SE, Fulton JN, Johnson GW, Li R, Dawant BM, Englot DJ, Bick SK, Roberson SW, Constantinidis C. Brain-wide human oscillatory local field potential activity during visual working memory. iScience 2024; 27:109130. [PMID: 38380249 PMCID: PMC10877957 DOI: 10.1016/j.isci.2024.109130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/10/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Oscillatory activity in the local field potential (LFP) is thought to be a marker of cognitive processes. To understand how it differentiates tasks and brain areas in humans, we recorded LFPs in 15 adults with intracranial depth electrodes, as they performed visual-spatial and shape working memory tasks. Stimulus appearance produced widespread, broad-band activation, including in occipital, parietal, temporal, insular, and prefrontal cortex, and the amygdala and hippocampus. Occipital cortex was characterized by most elevated power in the high-gamma (100-150 Hz) range during the visual stimulus presentation. The most consistent feature of the delay period was a systematic pattern of modulation in the beta frequency (16-40 Hz), which included a decrease in power of variable timing across areas, and rebound during the delay period. These results reveal the widespread nature of oscillatory activity across a broad brain network and region-specific signatures of oscillatory processes associated with visual working memory.
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Affiliation(s)
- Balbir Singh
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Zhengyang Wang
- Neuroscience Program, Vanderbilt University, Nashville, TN, USA
| | - Leen M. Madiah
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - S. Elizabeth Gatti
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Jenna N. Fulton
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Graham W. Johnson
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rui Li
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Benoit M. Dawant
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Dario J. Englot
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah K. Bick
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shawniqua Williams Roberson
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christos Constantinidis
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Neuroscience Program, Vanderbilt University, Nashville, TN, USA
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Gawęda Ł, Kowalski J, Aleksandrowicz A, Bagrowska P, Dąbkowska M, Pionke-Ubych R. A systematic review of performance-based assessment studies on cognitive biases in schizophrenia spectrum psychoses and clinical high-risk states: A summary of 40 years of research. Clin Psychol Rev 2024; 108:102391. [PMID: 38301343 DOI: 10.1016/j.cpr.2024.102391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 02/03/2024]
Abstract
Cognitive models of psychosis have stimulated empirical studies on cognitive biases involved in schizophrenia spectrum psychoses and their symptoms. This systematic review aimed to summarize the studies on the role of cognitive biases as assessed in different performance-based tasks in schizophrenia spectrum psychoses and clinical high-risk states. We focused on five cognitive biases linked to psychosis, i.e., aberrant salience, attentional biases, source monitoring biases, jumping to conclusions, and bias against disconfirmatory evidence. We identified N = 324 studies published in N = 308 articles fulfilling inclusion criteria. Most studies have been cross-sectional and confirmed that the schizophrenia spectrum psychoses are related to exaggerated cognitive biases compared to healthy controls. On the contrary, less evidence suggests a higher tendency for cognitive biases in the UHR sample. The only exceptions were source monitoring and jumping to conclusions, which were confirmed to be exaggerated in both clinical groups. Hallucinations and delusions were the most frequent symptoms studied in the context of cognitive biases. Based on the findings, we presented a hypothetical model on the role of interactions between cognitive biases or additive effects of biases in shaping the risk of psychosis. Future research is warranted for further development of cognitive models for psychosis.
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Affiliation(s)
- Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Joachim Kowalski
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Adrianna Aleksandrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Paulina Bagrowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Małgorzata Dąbkowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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Tan S, Jia Y, Jariwala N, Zhang Z, Brent K, Houde J, Nagarajan S, Subramaniam K. A randomised controlled trial investigating the causal role of the medial prefrontal cortex in mediating self-agency during speech monitoring and reality monitoring. Sci Rep 2024; 14:5108. [PMID: 38429404 PMCID: PMC10907680 DOI: 10.1038/s41598-024-55275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
Self-agency is the awareness of being the agent of one's own thoughts and actions. Self-agency is essential for interacting with the outside world (reality-monitoring). The medial prefrontal cortex (mPFC) is thought to be one neural correlate of self-agency. We investigated whether mPFC activity can causally modulate self-agency on two different tasks of speech-monitoring and reality-monitoring. The experience of self-agency is thought to result from making reliable predictions about the expected outcomes of one's own actions. This self-prediction ability is necessary for the encoding and memory retrieval of one's own thoughts during reality-monitoring to enable accurate judgments of self-agency. This self-prediction ability is also necessary for speech-monitoring where speakers consistently compare auditory feedback (what we hear ourselves say) with what we expect to hear while speaking. In this study, 30 healthy participants are assigned to either 10 Hz repetitive transcranial magnetic stimulation (rTMS) to enhance mPFC excitability (N = 15) or 10 Hz rTMS targeting a distal temporoparietal site (N = 15). High-frequency rTMS to mPFC enhanced self-predictions during speech-monitoring that predicted improved self-agency judgments during reality-monitoring. This is the first study to provide robust evidence for mPFC underlying a causal role in self-agency, that results from the fundamental ability of improving self-predictions across two different tasks.
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Affiliation(s)
- Songyuan Tan
- Department of Psychiatry, University of California, 513 Parnassus Avenue, HSE604, San Francisco, CA, 94143, USA
| | - Yingxin Jia
- Department of Psychiatry, University of California, 513 Parnassus Avenue, HSE604, San Francisco, CA, 94143, USA
| | - Namasvi Jariwala
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Zoey Zhang
- Department of Otolaryngology, University of California, San Francisco, San Francisco, CA, USA
| | - Kurtis Brent
- Department of Otolaryngology, University of California, San Francisco, San Francisco, CA, USA
| | - John Houde
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Srikantan Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Karuna Subramaniam
- Department of Psychiatry, University of California, 513 Parnassus Avenue, HSE604, San Francisco, CA, 94143, USA.
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Lee JH, Heo SY, Lee SW. Controlling human causal inference through in silico task design. Cell Rep 2024; 43:113702. [PMID: 38295800 DOI: 10.1016/j.celrep.2024.113702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/01/2023] [Accepted: 01/08/2024] [Indexed: 03/02/2024] Open
Abstract
Learning causal relationships is crucial for survival. The human brain's functional flexibility allows for effective causal inference, underlying various learning processes. While past studies focused on environmental factors influencing causal inference, a fundamental question remains: can these factors be manipulated for strategic causal inference control? This paper presents a task control framework for orchestrating causal learning task design. It utilizes a two-player game setting where a neural network learns to manipulate task variables by interacting with a human causal inference model. Training the task controller to generate experimental designs, we confirm its ability to accommodate complexities of environmental causal structure. Experiments involving 126 human subjects successfully validate the impact of task control on performance and learning efficiency. Additionally, we find that task control policy reflects the intrinsic nature of human causal inference: one-shot learning. This framework holds promising potential for applications paving the way for targeted behavioral outcomes in humans.
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Affiliation(s)
- Jee Hang Lee
- Department of Human-Centered AI, Sangmyung University, Seoul, Republic of Korea
| | - Su Yeon Heo
- Program of Brain and Cognitive Engineering, KAIST, Daejeon, Republic of Korea
| | - Sang Wan Lee
- Department of Brain and Cognitive Sciences, KAIST, Daejeon, Republic of Korea; Department of Bio and Brain Engineering, KAIST, Daejeon, Republic of Korea; Program of Brain and Cognitive Engineering, KAIST, Daejeon, Republic of Korea; KAIST Institute for Health Science and Technology, Daejeon, Republic of Korea; KAIST Institute for Artificial Intelligence, Daejeon, Republic of Korea; KAIST Center for Neuroscience-inspired AI, Daejeon, Republic of Korea.
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11
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Jia Y, Kudo K, Jariwala N, Tarapore P, Nagarajan S, Subramaniam K. Causal role of medial superior frontal cortex on enhancing neural information flow and self-agency judgments in the self-agency network. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.13.24302764. [PMID: 38405834 PMCID: PMC10888992 DOI: 10.1101/2024.02.13.24302764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Self-agency is being aware of oneself as the agent of one's thoughts and actions. Self-agency is necessary for successful interactions with the outside world (reality-monitoring). Prior research has shown that the medial superior prefrontal gyri (mPFC/SFG) may represent one neural correlate underlying self-agency judgments. However, the causal relationship remains unknown. Here, we applied high-frequency 10Hz repetitive transcranial magnetic stimulation (rTMS) to modulate the excitability of the mPFC/SFG site that we have previously shown to mediate self-agency. For the first time, we delineate causal neural mechanisms, revealing precisely how rTMS modulates SFG excitability and impacts directional neural information flow in the self-agency network by implementing innovative magnetoencephalography (MEG) phase-transfer entropy (PTE) metrics, measured from pre-to-post rTMS. We found that, compared to control rTMS, enhancing SFG excitability by rTMS induced significant increases in information flow between SFG and specific cingulate and paracentral regions in the self-agency network in delta-theta, alpha, and gamma bands, which predicted improved self-agency judgments. This is the first multimodal imaging study in which we implement MEG PTE metrics of 5D imaging of space, frequency and time, to provide cutting-edge analyses of the causal neural mechanisms of how rTMS enhances SFG excitability and improves neural information flow between distinct regions in the self-agency network to potentiate improved self-agency judgments. Our findings provide a novel perspective for investigating causal neural mechanisms underlying self-agency and create a path towards developing novel neuromodulation interventions to improve self-agency that will be particularly useful for patients with psychosis who exhibit severe impairments in self-agency.
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12
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Kang K, Antonenko D, Glöckner F, Flöel A, Li SC. Neural correlates of home-based intervention effects on value-based sequential decision-making in healthy older adults. AGING BRAIN 2024; 5:100109. [PMID: 38380149 PMCID: PMC10876581 DOI: 10.1016/j.nbas.2024.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
Older adults demonstrate difficulties in sequential decision-making, which is partly attributed to under-recruitment of prefrontal networks. It is, therefore, important to understand the mechanisms that may improve this ability. This study investigated the effectiveness of an 18-sessions, home-based cognitive intervention and the neural mechanisms that underpin individual differences in intervention effects. Participants were required to learn sequential choices in a 3-stage Markov decision-making task that would yield the most rewards. Participants were assigned to better or worse responders group based on their performance at the last intervention session (T18). Better responders improved significantly starting from the fifth intervention session while worse responders did not improve across all training sessions. At post-intervention, only better responders showed condition-dependent modulation of the dorsolateral prefrontal cortex (DLPFC) as measured by fNIRS, with higher DLPFC activity in the delayed condition. Despite large individual differences, our data showed that value-based sequential-decision-making and its corresponding neural mechanisms can be remediated via home-based cognitive intervention in some older adults; moreover, individual differences in recruiting prefrontal activities after the intervention are associated with variations in intervention outcomes. Intervention-related gains were also maintained at three months after post-intervention. However, future studies should investigate the potential of combining other intervention methods such as non-invasive brain stimulation with cognitive intervention for older adults who do not respond to the intervention, thus emphasizing the importance of developing individualized intervention programs for older adults.
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Affiliation(s)
- Kathleen Kang
- Chair of Lifespan Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Daria Antonenko
- Department of Neurology, University Medicine of Greifswald, Greifswald, Germany
| | - Franka Glöckner
- Chair of Lifespan Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine of Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, Greifswald, Germany
| | - Shu-Chen Li
- Chair of Lifespan Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop, Technische Universität Dresden, Dresden, Germany
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13
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Damiani S, Cavicchioli M, Guiot C, Donadeo A, Scalabrini A, Grecuzzo V, Bergamaschini I, Provenzani U, Politi P, Fusar-Poli P. The noise in our brain: A systematic review and meta-analysis of neuroimaging and signal-detection studies on source monitoring in psychosis. J Psychiatr Res 2024; 169:142-151. [PMID: 38039688 DOI: 10.1016/j.jpsychires.2023.11.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/09/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES Noisy thoughts or perceptions are characteristics of psychosis (PSY) and, they are deeply related to source monitoring (SM) - the ability to discriminate the origin of internal/external experiences. METHODS This MOOSE, PRISMA-compliant meta-analysis compared SM performances in PSY compared to healthy controls (HC) focusing on signal-to-noise discrimination in order to: i) test whether neuroimaging procedures (fMRI/EEG) might be a group-specific source of noise for SM; ii) compare error- and accuracy-based indexes; iii) to meta-analyze signal-detection measures (i.e., discrimination index and response bias); iv) to determine the best index capturing SM deficits in psychosis. We conducted a 3-level meta-analysis for each aim to estimate pooled effect-sizes (Cohen's d). SM type, source discrimination and stimulus modality were used as meta-regressors. Heterogeneity (I2), publication bias (Egger's test) and multiple comparisons (Bonferroni correction) were considered. RESULTS Sixteen neuroimaging, 44 error/accuracy-based behavioral and 7 signal-detection trials were included (2297 PSY, age range = 18.78-52.6; 1745 HC, age range = 21.1-53.3). The noise generated by neuroimaging procedures slightly influenced error, but not accuracy. Accuracy-based (d = -0.83), but not error-based, indexes showed significant and large SM impairments in PSY compared to HC. Overall SM performance differences between PSY and HC were larger in discrimination index (d = -0.65) and accuracy (d = -0.61), followed by response bias (d = -0.59, ns) and error-based (d = 0.35) indexes. CONCLUSION Although both accuracy and discrimination indexes differentiate patients with PSY from HC, discrimination index is more reliable and may better capture the bi-directional nature of the internal/external source confusion.
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Affiliation(s)
- Stefano Damiani
- University of Pavia, Department of Brain and Behavioral Sciences, Italy.
| | - Marco Cavicchioli
- University Vita-Salute San Raffaele, Department of Psychology, Italy
| | - Cecilia Guiot
- University of Pavia, Department of Brain and Behavioral Sciences, Italy
| | - Alberto Donadeo
- University of Pavia, Department of Brain and Behavioral Sciences, Italy
| | - Andrea Scalabrini
- University of Bergamo, Department of Human and Social Science, Italy
| | | | | | | | - Pierluigi Politi
- University of Pavia, Department of Brain and Behavioral Sciences, Italy
| | - Paolo Fusar-Poli
- University of Pavia, Department of Brain and Behavioral Sciences, Italy; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
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14
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Ballı M, Doğan AE, Eser HY. Improving Psychiatry Services with Artificial Intelligence: Opportunities and Challenges. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:317-328. [PMID: 39783807 PMCID: PMC11681275 DOI: 10.5080/u27604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Accepted: 11/27/2024] [Indexed: 01/12/2025]
Abstract
Mental disorders are a critical global public health problem due to their increasing prevalence, rising costs, and significant economic burden. Despite efforts to increase the mental health workforce in Türkiye, there is a significant shortage of psychiatrists, limiting the quality and accessibility of mental health services. This review examines the potential of artificial intelligence (AI), especially large language models, to transform psychiatric care in the world and in Türkiye. AI technologies, including machine learning and deep learning, offer innovative solutions for the diagnosis, personalization of treatment, and monitoring of mental disorders using a variety of data sources, such as speech patterns, neuroimaging, and behavioral measures. Although AI has shown promising capabilities in improving diagnostic accuracy and access to mental health services, challenges such as algorithmic biases, data privacy concerns, ethical implications, and the confabulation phenomenon of large language models prevent the full implementation of AI in practice. The review highlights the need for interdisciplinary collaboration to develop culturally and linguistically adapted AI tools, particularly in the Turkish context, and suggests strategies such as fine-tuning, retrieval-augmented generation, and reinforcement learning from human feedback to increase AI reliability. Advances suggest that AI can improve mental health care by increasing diagnostic accuracy and accessibility while preserving the essential human elements of medical care. Current limitations need to be addressed through rigorous research and ethical frameworks for effective and equitable integration of AI into mental health care. Keywords: Artificial İntelligence, Health, Large Language Model, Machine Learning, Psychiatry.
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Affiliation(s)
- Muhammed Ballı
- PhD Candidate, Koç University, Graduate School of Health Sciences, Istanbul, Turkey
| | - Aslı Ercan Doğan
- Psychiatrist, Koç University School of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Hale Yapıcı Eser
- Assoc. Prof., Koç University School of Medicine, Department of Psychiatry, Istanbul, Turkey
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15
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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] [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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16
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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: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [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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17
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Hinkley LBN, Haas SS, Cheung SW, Nagarajan SS, Subramaniam K. Reduced neural connectivity in the caudate anterior head predicts hallucination severity in schizophrenia. Schizophr Res 2023; 261:1-5. [PMID: 37678144 PMCID: PMC10878029 DOI: 10.1016/j.schres.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/13/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Caudate functional abnormalities have been identified as one critical neural substrate underlying sensory gating impairments that lead to auditory phantom hallucinations in both patients with schizophrenia (SZ) and tinnitus, characterized by the perception of internally generated sounds in the absence of external environmental auditory stimuli. In this study, we tested the hypothesis as to whether functional connectivity abnormalities in distinct caudate subdivisions implicated in sensory gating and auditory phantom percepts in tinnitus, which are currently being localized for neuromodulation targeting using deep brain stimulation techniques, would be associated with auditory phantom hallucination severity in SZ. METHODS Twenty five SZ and twenty eight demographically-matched healthy control (HC) participants, completed this fMRI resting-state study and clinical assessments. RESULTS Between-group seed-to-voxel analyses revealed only one region, the caudate anterior head, which showed reduced functional connectivity with the thalamus that survived whole-brain multiple comparison corrections. Importantly, connectivity between the caudate anterior head with thalamus negatively correlated with hallucination severity. CONCLUSIONS In the present study, we deliver the first evidence of caudate subdivision specificity for the neural pathophysiology underlying hallucinations in schizophrenia within a sensory gating framework that has been developed for auditory phantoms in patients with tinnitus. Our findings provide transdiagnostic convergent evidence for the role of the caudate in the gating of auditory phantom hallucinations, observed across patients with SZ and tinnitus by specifying the anterior caudate division is key to mediation of hallucinations, and creating a path towards personalized treatment approaches to arrest auditory phantom hallucinations from reaching perceptual awareness.
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Affiliation(s)
- Leighton B N Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USA
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY 10029, USA
| | - Steven W Cheung
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA 94143, USA; Surgical Services, San Francisco Veterans Health Care System, San Francisco, CA 94121, USA
| | - Srikantan S Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USA
| | - Karuna Subramaniam
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94143, USA.
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Lemmers-Jansen I, Velthorst E, Fett AK. The social cognitive and neural mechanisms that underlie social functioning in individuals with schizophrenia - a review. Transl Psychiatry 2023; 13:327. [PMID: 37865631 PMCID: PMC10590451 DOI: 10.1038/s41398-023-02593-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 10/23/2023] Open
Abstract
In many individuals with a diagnosis of schizophrenia social functioning is impaired across the lifespan. Social cognition has emerged as one of the possible factors that may contribute to these challenges. Neuroimaging research can give further insights into the underlying mechanisms of social (cognitive) difficulties. This review summarises the evidence on the associations between social cognition in the domains of theory of mind and emotion perception and processing, and individuals' social functioning and social skills, as well as associated neural mechanisms. Eighteen behavioural studies were conducted since the last major review and meta-analysis in the field (inclusion between 7/2017 and 1/2022). No major review has investigated the link between the neural mechanisms of social cognition and their association with social functioning in schizophrenia. Fourteen relevant studies were included (from 1/2000 to 1/2022). The findings of the behavioural studies showed that associations with social outcomes were slightly stronger for theory of mind than for emotion perception and processing. Moreover, performance in both social cognitive domains was more strongly associated with performance on social skill measures than questionnaire-based assessment of social functioning in the community. Studies on the underlying neural substrate of these associations presented mixed findings. In general, higher activation in various regions of the social brain was associated with better social functioning. The available evidence suggests some shared regions that might underlie the social cognition-social outcome link between different domains. However, due to the heterogeneity in approaches and findings, the current knowledge base will need to be expanded before firm conclusions can be drawn.
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Affiliation(s)
- Imke Lemmers-Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (iBBA) Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eva Velthorst
- GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands
| | - Anne-Kathrin Fett
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Department of Psychology, City, University of London, London, UK.
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Hao X, Jia Y, Chen J, Zou C, Jiang C. Subthreshold Depression: A Systematic Review and Network Meta-Analysis of Non-Pharmacological Interventions. Neuropsychiatr Dis Treat 2023; 19:2149-2169. [PMID: 37867932 PMCID: PMC10588757 DOI: 10.2147/ndt.s425509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Abstract
Background Subthreshold depression (StD) is considered to be the "precursor" stage of major depressive disorder (MDD), which could cause higher risk of suicide, disease burden and functional impairment. There have been various non-pharmacological interventions for StD. However, the comparison of their effectiveness still lacks sufficient evidence. We performed a systematic review and network meta-analysis to evaluate and rank the efficacy of multiple non-pharmacological interventions targeting StD. Methods We conducted a thorough search across various databases including PubMed, Medline, Embase, Web of Science and PsycINFO from inception to December 2022. All included studies were randomized controlled trials (RCTs) of non-pharmacological interventions for patients with StD compared with control group (CG). Several universal scales for measuring depression severity were used as efficacy outcomes. The surface under the cumulative ranking curve (SUCRA) was used to separately rank each intervention using the "Stata 17.0" software. Results A total of thirty-six trials were included, involving twenty-eight interventions and 7417 participants. The research found that most non-pharmacological interventions were superior to controls for StD. In each outcome evaluation by different scales for measuring depression, psychotherapy always ranked first in terms of treatment effectiveness, especially Problem-solving Therapy (PST), Behavioral Activation Therapy (BAT), Cognitive Behavioral Therapy (CBT)/Internet-based CBT (I-CBT)/Telephone-based CBT (T-CBT). Since different groups could not be directly compared, the total optimal intervention could not be determined. Conclusion Here, we show that psychotherapy may be the better choice for the treatment of StD. This study provides some evidence on StD management selection for clinical workers. However, to establish its intervention effect more conclusively, the content, format and operators of psychotherapy still require extensive exploration to conduct more effective, convenient and cost-effective implementation in primary healthcare. Notably, further research is also urgently needed to find the biological and neural mechanisms of StD by examining whether psychotherapy alters neuroplasticity in patients with StD.
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Affiliation(s)
- Xiaofei Hao
- Department of General Medicine, Chengdu Fifth People’s Hospital, Chengdu, Sichuan, 611130, People’s Republic of China
| | - Yuying Jia
- Department of Outpatient, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, People’s Republic of China
| | - Jie Chen
- Department of Outpatient, The General Hospital of Western Theater Command, Chengdu, Sichuan, 610083, People’s Republic of China
| | - Chuan Zou
- Department of General Medicine, Chengdu Fifth People’s Hospital, Chengdu, Sichuan, 611130, People’s Republic of China
| | - Cuinan Jiang
- Department of General Surgery, The Third People’s Hospital of Chengdu & The Affiliated Hospital of Southwest Jiaotong University, Chengdu, Sichuan, 610031, People’s Republic of China
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20
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Tan S, Jia Y, Jariwala N, Zhang Z, Brent K, Houde J, Nagarajan S, Subramaniam K. A randomised controlled trial investigating the causal role of the medial prefrontal cortex in mediating self-agency during speech monitoring and reality monitoring. RESEARCH SQUARE 2023:rs.3.rs-3280599. [PMID: 37790323 PMCID: PMC10543504 DOI: 10.21203/rs.3.rs-3280599/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Self-agency is being aware of oneself as the agent of one's thoughts and actions. Self agency is necessary for successful interactions with the external world (reality-monitoring). The medial prefrontal cortex (mPFC) is considered to represent one neural correlate underlying self-agency. We investigated whether mPFC activity can causally modulate self-agency on two different tasks involving speech-monitoring and reality-monitoring. The experience of self-agency is thought to result from being able to reliably predict the sensory outcomes of one's own actions. This self-prediction ability is necessary for successfully encoding and recalling one's own thoughts to enable accurate self-agency judgments during reality-monitoring tasks. This self-prediction ability is also necessary during speech-monitoring tasks where speakers compare what we hear ourselves say in auditory feedback with what we predict we will hear while speaking. In this randomised-controlled study, heathy controls (HC) are assigned to either high-frequency transcranial magnetic stimulation (TMS) to enhance mPFC excitability or TMS targeting a control site. After TMS to mPFC, HC improved self-predictions during speech-monitoring tasks that predicted improved self-agency judgments during different reality-monitoring tasks. These first-in-kind findings demonstrate the mechanisms of how mPFC plays a causal role in self-agency that results from the fundamental ability of improving self-predictions across two different tasks.
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Affiliation(s)
- Songyuan Tan
- University of California San Francisco Medical Center
| | - Yingxin Jia
- University of California San Francisco Medical Center
| | | | - Zoey Zhang
- University of California San Francisco Medical Center
| | - Kurtis Brent
- University of California San Francisco Medical Center
| | - John Houde
- University of California San Francisco Medical Center
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21
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Singh B, Wang Z, Madiah LM, Gatti SE, Fulton JN, Johnson GW, Li R, Dawant BM, Englot DJ, Bick SK, Roberson SW, Constantinidis C. Brain-wide human oscillatory LFP activity during visual working memory. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.06.556554. [PMID: 37732263 PMCID: PMC10508766 DOI: 10.1101/2023.09.06.556554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Oscillatory activity is thought to be a marker of cognitive processes, although its role and distribution across the brain during working memory has been a matter of debate. To understand how oscillatory activity differentiates tasks and brain areas in humans, we recorded local field potentials (LFPs) in 12 adults as they performed visual-spatial and shape-matching memory tasks. Tasks were designed to engage working memory processes at a range of delay intervals between stimulus delivery and response initiation. LFPs were recorded using intracranial depth electrodes implanted to localize seizures for management of intractable epilepsy. Task-related LFP power analyses revealed an extensive network of cortical regions that were activated during the presentation of visual stimuli and during their maintenance in working memory, including occipital, parietal, temporal, insular, and prefrontal cortical areas, and subcortical structures including the amygdala and hippocampus. Across most brain areas, the appearance of a stimulus produced broadband power increase, while gamma power was evident during the delay interval of the working memory task. Notable differences between areas included that occipital cortex was characterized by elevated power in the high gamma (100-150 Hz) range during the 500 ms of visual stimulus presentation, which was less pronounced or absent in other areas. A decrease in power centered in beta frequency (16-40 Hz) was also observed after the stimulus presentation, whose magnitude differed across areas. These results reveal the interplay of oscillatory activity across a broad network, and region-specific signatures of oscillatory processes associated with visual working memory.
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Affiliation(s)
- Balbir Singh
- Department of Biomedical Engineering, Vanderbilt University
| | | | - Leen M Madiah
- Department of Biomedical Engineering, Vanderbilt University
| | | | - Jenna N Fulton
- Department of Neurology, Vanderbilt University Medical Center
| | - Graham W Johnson
- Department of Neurological Surgery, Vanderbilt University Medical Center
| | - Rui Li
- Department of Electrical and Computer Engineering, Vanderbilt University
| | - Benoit M Dawant
- Department of Electrical and Computer Engineering, Vanderbilt University
| | - Dario J Englot
- Department of Biomedical Engineering, Vanderbilt University
- Department of Neurological Surgery, Vanderbilt University Medical Center
| | - Sarah K Bick
- Department of Biomedical Engineering, Vanderbilt University
- Department of Neurological Surgery, Vanderbilt University Medical Center
| | - Shawniqua Williams Roberson
- Department of Biomedical Engineering, Vanderbilt University
- Department of Neurology, Vanderbilt University Medical Center
| | - Christos Constantinidis
- Department of Biomedical Engineering, Vanderbilt University
- Neuroscience Program, Vanderbilt University
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center
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22
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Lavallé L, Brunelin J, Jardri R, Haesebaert F, Mondino M. The neural signature of reality-monitoring: A meta-analysis of functional neuroimaging studies. Hum Brain Mapp 2023; 44:4372-4389. [PMID: 37246722 PMCID: PMC10318245 DOI: 10.1002/hbm.26387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/21/2023] [Accepted: 05/11/2023] [Indexed: 05/30/2023] Open
Abstract
Distinguishing imagination and thoughts from information we perceived from the environment, a process called reality-monitoring, is important in everyday situations. Although reality monitoring seems to overlap with the concept of self-monitoring, which allows one to distinguish self-generated actions or thoughts from those generated by others, the two concepts remain largely separate cognitive domains and their common brain substrates have received little attention. We investigated the brain regions involved in these two cognitive processes and explored the common brain regions they share. To do this, we conducted two separate coordinate-based meta-analyses of functional magnetic resonance imaging studies assessing the brain regions involved in reality- and self-monitoring. Few brain regions survived threshold-free cluster enhancement family-wise multiple comparison correction (p < .05), likely owing to the small number of studies identified. Using uncorrected statistical thresholds recommended by Signed Differential Mapping with Permutation of Subject Images, the meta-analysis of reality-monitoring studies (k = 9 studies including 172 healthy subjects) revealed clusters in the lobule VI of the cerebellum, the right anterior medial prefrontal cortex and anterior thalamic projections. The meta-analysis of self-monitoring studies (k = 12 studies including 192 healthy subjects) highlighted the involvement of a set of brain regions including the lobule VI of the left cerebellum and fronto-temporo-parietal regions. We showed with a conjunction analysis that the lobule VI of the cerebellum was consistently engaged in both reality- and self-monitoring. The current findings offer new insights into the common brain regions underlying reality-monitoring and self-monitoring, and suggest that the neural signature of the self that may occur during self-production should persist in memories.
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Affiliation(s)
- Layla Lavallé
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2BronFrance
- CH le VinatierBronFrance
| | - Jérôme Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2BronFrance
- CH le VinatierBronFrance
| | - Renaud Jardri
- Université de Lille, INSERM U‐1172, Lille Neurosciences & Cognition, Plasticity & Subjectivity TeamLilleFrance
| | - Frédéric Haesebaert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2BronFrance
- CH le VinatierBronFrance
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2BronFrance
- CH le VinatierBronFrance
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23
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Bava JM, Wang Z, Bick SK, Englot DJ, Constantinidis C. Improving Visual Working Memory with Cholinergic Deep Brain Stimulation. Brain Sci 2023; 13:917. [PMID: 37371395 PMCID: PMC10296349 DOI: 10.3390/brainsci13060917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Acetylcholine is a critical modulatory neurotransmitter for cognitive function. Cholinergic drugs improve cognitive performance and enhance neuronal activity in the sensory and association cortices. An alternative means of improving cognitive function is through the use of deep brain stimulation. Prior animal studies have demonstrated that stimulation of the nucleus basalis of Meynert through DBS improves cognitive performance on a visual working memory task to the same degree as cholinesterase inhibitors. Additionally, unlike current pharmacological treatments for neurocognitive disorders, DBS does not lose efficacy over time and adverse effects are rare. These findings suggest that DBS may be a promising alternative for treating cognitive impairments in neurodegenerative disorders such as Alzheimer's disease. Thus, further research and human trials should be considered to assess the potential of DBS as a therapeutic treatment for these disorders.
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Affiliation(s)
- Janki M. Bava
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; (J.M.B.); (D.J.E.)
| | - Zhengyang Wang
- Neuroscience Program, Vanderbilt University, Nashville, TN 37235, USA;
| | - Sarah K. Bick
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Dario J. Englot
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; (J.M.B.); (D.J.E.)
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Christos Constantinidis
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; (J.M.B.); (D.J.E.)
- Neuroscience Program, Vanderbilt University, Nashville, TN 37235, USA;
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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24
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Kim KX, Dale CL, Ranasinghe KG, Kothare H, Beagle AJ, Lerner H, Mizuiri D, Gorno-Tempini ML, Vossel K, Nagarajan SS, Houde JF. Impaired Speaking-Induced Suppression in Alzheimer's Disease. eNeuro 2023; 10:ENEURO.0056-23.2023. [PMID: 37221089 PMCID: PMC10249944 DOI: 10.1523/eneuro.0056-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/04/2023] [Indexed: 05/25/2023] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease involving cognitive impairment and abnormalities in speech and language. Here, we examine how AD affects the fidelity of auditory feedback predictions during speaking. We focus on the phenomenon of speaking-induced suppression (SIS), the auditory cortical responses' suppression during auditory feedback processing. SIS is determined by subtracting the magnitude of auditory cortical responses during speaking from listening to playback of the same speech. Our state feedback control (SFC) model of speech motor control explains SIS as arising from the onset of auditory feedback matching a prediction of that feedback onset during speaking, a prediction that is absent during passive listening to playback of the auditory feedback. Our model hypothesizes that the auditory cortical response to auditory feedback reflects the mismatch with the prediction: small during speaking, large during listening, with the difference being SIS. Normally, during speaking, auditory feedback matches its predictions, then SIS will be large. Any reductions in SIS will indicate inaccuracy in auditory feedback prediction not matching the actual feedback. We investigated SIS in AD patients [n = 20; mean (SD) age, 60.77 (10.04); female (%), 55.00] and healthy controls [n = 12; mean (SD) age, 63.68 (6.07); female (%), 83.33] through magnetoencephalography (MEG)-based functional imaging. We found a significant reduction in SIS at ∼100 ms in AD patients compared with healthy controls (linear mixed effects model, F (1,57.5) = 6.849, p = 0.011). The results suggest that AD patients generate inaccurate auditory feedback predictions, contributing to abnormalities in AD speech.
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Affiliation(s)
- Kyunghee X Kim
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA 94117
| | - Corby L Dale
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94117
| | - Kamalini G Ranasinghe
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158
| | - Hardik Kothare
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94117
| | - Alexander J Beagle
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158
| | - Hannah Lerner
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158
| | - Danielle Mizuiri
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94117
| | | | - Keith Vossel
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158
| | - Srikantan S Nagarajan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94117
| | - John F Houde
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA 94117
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25
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Singh J, Singh S, Gupta S, Chavan BS. Cognitive Remediation and Schizophrenia: Effects on Brain Complexity. Neurosci Lett 2023; 808:137268. [PMID: 37100222 DOI: 10.1016/j.neulet.2023.137268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 04/28/2023]
Abstract
The objective of this study is to investigate nonlinear neural dynamics of chronic patients with schizophrenia following 3 months of cognitive remediation and to find correlations with neuropsychological measures of cognition. Twenty nine patients were randomized to Cognitive Training (CT) and Treatment as Usual (TAU) group. The system complexity is estimated by Correlation Dimension (D2) and Largest Lyapunov Exponent (LLE) from the reconstructed attractor of the underlying system. Significant increase in dimensional complexity (D2) over time is observed in prefrontal and medial frontal-central regions in eyes open and arithmetic condition; and posterior parietal-occipital region under eyes closed after 3 months. Dynamical complexity (LLE) significantly decreased over time in medial left central region under eyes closed and eyes open condition; prefrontal region in eyes open and lateral right temporal region in arithmetic condition. Interaction is significant for medial left central region with TAU group exhibiting greater decrease in LLE compared to CT group. The CT group showed significant correlation of increased D2 with focused attention. In this study it is found that patients with schizophrenia exhibit higher dimensional and lower dynamical complexity over time indicating improvement in neurodynamics of underlying physiological system.
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Affiliation(s)
- Jaskirat Singh
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India
| | - Sukhwinder Singh
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India.
| | - Savita Gupta
- Computational Neuroscience Lab, UIET, Panjab University, Chandigarh Pincode: 160014, India.
| | - B S Chavan
- Department of Psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh, Pincode:160032, India.
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26
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Hong J, Su Y, Wang J, Xu X, Qu W, Fan H, Tan Y, Wang Z, Zhao Y, Tan S. Association between video gaming time and cognitive functions: A cross-sectional study of Chinese children and adolescents. Asian J Psychiatr 2023; 84:103584. [PMID: 37075676 DOI: 10.1016/j.ajp.2023.103584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/26/2023] [Accepted: 04/07/2023] [Indexed: 04/21/2023]
Abstract
This study sought to explore relationships between video gaming time and cognitive functioning in children and adolescents to provide a scientific reference for a reasonable time range of game use. A total of 649 participants aged 6-18 years were recruited through an online survey using convenience sampling. We used a combination of multiple linear regression models, smoothing splines, piecewise linear regression models, and log-likelihood ratio tests to comprehensively analyze the linear and nonlinear relationships between video gaming time and cognitive functions. Neurocognitive functioning was assessed using the digit symbol test, spatial span back test, Stroop task, and Wisconsin card sorting test. Facial and voice emotion recognition tests were used to evaluate social cognitive functioning. Video gaming time had a saturation effect on improving correct answers to the digit symbol test, which means that performance did not increase with increasing video gaming time when the video gaming duration reached 20 h/week (adjusted β = -0.58; 95% CI: -1.22, 0.05). Furthermore, both the relationship between video gaming time and the Wisconsin Card Sorting Test and the facial emotion recognition score showed a threshold effect. The completed categories of the Wisconsin Card Sorting Test began to decline after 17 h/week of playtime, and a decline in facial emotion recognition occurred after playing video games for over 20 h/week. These results suggest that children and adolescents should restrict their video gaming time to within a certain range, which could help reduce the negative effects of video games and retain their positive effects.
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Affiliation(s)
- Jiangyue Hong
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Yi Su
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Jinghan Wang
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Xuejing Xu
- Temple University, Philadelphia, Pennsylvania, 19122, USA
| | - Wei Qu
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Hongzhen Fan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Yunlong Tan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Zhiren Wang
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Yanli Zhao
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Shuping Tan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China.
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27
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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: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [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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28
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Sampedro A, Ibarretxe-Bilbao N, Peña J, Cabrera-Zubizarreta A, Sánchez P, Gómez-Gastiasoro A, Iriarte-Yoller N, Pavón C, Tous-Espelosin M, Ojeda N. Analyzing structural and functional brain changes related to an integrative cognitive remediation program for schizophrenia: A randomized controlled trial. Schizophr Res 2023; 255:82-92. [PMID: 36965364 DOI: 10.1016/j.schres.2023.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/07/2023] [Accepted: 03/11/2023] [Indexed: 03/27/2023]
Abstract
Cognitive remediation has been shown to improve cognition in schizophrenia, but little is known about the specific functional and structural brain changes related to the implementation of an integrative cognitive remediation program. This study analyzed the functional and structural brain changes identified after implementing an integrative cognitive remediation program, REHACOP, in schizophrenia. The program combined cognitive remediation, social cognitive training, and functional and social skills training. The sample included 59 patients that were assigned to either the REHACOP group or an active control group for 20 weeks. In addition to a clinical and neuropsychological assessment, T1-weighted, diffusion-weighted and functional magnetic resonance images were acquired during a resting-state and during a memory paradigm, both at baseline and follow-up. Voxel-based morphometry, tract-based spatial statistics, resting-state functional connectivity, and brain activation analyses during the memory paradigm were performed. Brain changes were assessed with a 2 × 2 repeated-measure analysis of covariance for group x time interaction. Intragroup paired t-tests were also carried out. Repeated-measure analyses revealed improvements in cognition and functional outcome, but no significant brain changes associated with the integrative cognitive remediation program. Intragroup analyses showed greater gray matter volume and cortical thickness in right temporal regions at post-treatment in the REHACOP group. The absence of significant brain-level results associated with cognitive remediation may be partly due to the small sample size, which limited the statistical power of the study. Therefore, further research is needed to clarify whether the temporal lobe may be a key area involved in cognitive improvements following cognitive remediation.
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Affiliation(s)
- Agurne Sampedro
- University of Deusto, Faculty of Health Sciences, Department of Psychology, Bilbao, Spain
| | - Naroa Ibarretxe-Bilbao
- University of Deusto, Faculty of Health Sciences, Department of Psychology, Bilbao, Spain
| | - Javier Peña
- University of Deusto, Faculty of Health Sciences, Department of Psychology, Bilbao, Spain.
| | | | - Pedro Sánchez
- Bioaraba, New Therapies in Mental Health, Osakidetza Basque Health Service, Araba Mental Health Service, Alava Psychiatric Hospital, Vitoria-Gasteiz, Spain; University of Deusto, Faculty of Health Sciences, Department of Medicine, Bilbao, Spain
| | - Ainara Gómez-Gastiasoro
- University of the Basque Country (UPV/EHU), Faculty of Psychology, Department of Basic Psychological Processes and Development, Donostia, Spain
| | - Nagore Iriarte-Yoller
- Bioaraba, New Therapies in Mental Health, Osakidetza Basque Health Service, Araba Mental Health Service, Alava Psychiatric Hospital, Vitoria-Gasteiz, Spain
| | - Cristóbal Pavón
- Bioaraba, New Therapies in Mental Health, Osakidetza Basque Health Service, Araba Mental Health Service, Alava Psychiatric Hospital, Vitoria-Gasteiz, Spain
| | - Mikel Tous-Espelosin
- University of the Basque Country (UPV/EHU), Faculty of Education and Sport, Department of Physical Education and Sport, Vitoria-Gasteiz, Spain
| | - Natalia Ojeda
- University of Deusto, Faculty of Health Sciences, Department of Psychology, Bilbao, Spain
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29
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Tseng A, DuBois M, Biagianti B, Brumley C, Jacob S. Auditory Domain Sensitivity and Neuroplasticity-Based Targeted Cognitive Training in Autism Spectrum Disorder. J Clin Med 2023; 12:jcm12041635. [PMID: 36836168 PMCID: PMC9960486 DOI: 10.3390/jcm12041635] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/27/2023] [Accepted: 02/12/2023] [Indexed: 02/22/2023] Open
Abstract
Sensory processing, along with the integration of external inputs into stable representations of the environment, is integral to social cognitive functioning; challenges in these processes have been reported in Autism Spectrum Disorder (ASD) since the earliest descriptions of autism. Recently, neuroplasticity-based targeted cognitive training (TCT) has shown promise as an approach to improve functional impairments in clinical patients. However, few computerized and adaptive brain-based programs have been trialed in ASD. For individuals with sensory processing sensitivities (SPS), the inclusion of some auditory components in TCT protocols may be aversive. Thus, with the goal of developing a web-based, remotely accessible intervention that incorporates SPS concerns in the auditory domain, we assessed auditory SPS in autistic adolescents and young adults (N = 25) who started a novel, computerized auditory-based TCT program designed to improve working memory and information processing speed and accuracy. We found within-subject gains across the training program and between pre/post-intervention assessments. We also identified auditory, clinical, and cognitive characteristics that are associated with TCT outcomes and program engagement. These initial findings may be used to inform therapeutic decisions about which individuals would more likely engage in and benefit from an auditory-based, computerized TCT program.
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Affiliation(s)
- Angela Tseng
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
- Correspondence: (A.T.); (S.J.)
| | - Megan DuBois
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bruno Biagianti
- Department of Psychology, University of Milano-Bicocca, 20122 Milan, Italy
| | - Caroline Brumley
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Suma Jacob
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
- Correspondence: (A.T.); (S.J.)
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30
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Jia Y, Jariwala N, Hinkley LBN, Nagarajan S, Subramaniam K. Abnormal resting-state functional connectivity underlies cognitive and clinical symptoms in patients with schizophrenia. Front Hum Neurosci 2023; 17:1077923. [PMID: 36875232 PMCID: PMC9976937 DOI: 10.3389/fnhum.2023.1077923] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction The cognitive and psychotic symptoms in patients with schizophrenia (SZ) are thought to result from disrupted brain network connectivity. Methods We capitalize on the high spatiotemporal resolution of magnetoencephalography imaging (MEG) to record spontaneous neuronal activity in resting state networks in 21 SZ compared with 21 healthy controls (HC). Results We found that SZ showed significant global disrupted functional connectivity in delta-theta (2-8 Hz), alpha (8-12 Hz), and beta (12-30 Hz) frequencies, compared to HC. Disrupted global connectivity in alpha frequencies with bilateral frontal cortices was associated with more severe clinical psychopathology (i.e., positive psychotic symptoms). Specifically, aberrant connectivity in beta frequencies between the left primary auditory cortex and cerebellum, was linked to greater hallucination severity in SZ. Disrupted connectivity in delta-theta frequencies between the medial frontal and left inferior frontal cortex was associated with impaired cognition. Discussion The multivariate techniques employed in the present study highlight the importance of applying our source reconstruction techniques which leverage the high spatial localization abilities of MEG for estimating neural source activity using beamforming methods such as SAM (synthetic aperture morphometry) to reconstruct the source of brain activity, together with functional connectivity assessments, assayed with imaginary coherence metrics, to delineate how neurophysiological dysconnectivity in specific oscillatory frequencies between distinct regions underlie the cognitive and psychotic symptoms in SZ. The present findings employ powerful techniques in spatial and time-frequency domains to provide potential neural biomarkers underlying neuronal network dysconnectivity in SZ that will inform the development of 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, San Francisco, CA, United States
| | - Namasvi Jariwala
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Leighton B. N. Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Srikantan Nagarajan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Karuna Subramaniam
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
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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: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [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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32
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Mororó LG, Guimarães AL, Costa AC, Genaro L, Cavalcanti MT, Scoriels L, Panizzutti R. Association between motivation and engagement with changes in cognition and symptoms after digital cognitive training in schizophrenia. Schizophr Res 2023; 251:1-9. [PMID: 36527953 DOI: 10.1016/j.schres.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/14/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Digital cognitive training can remediate cognitive deficits present in schizophrenia. However, limited motivation and engagement may impact adherence to training. Therefore, identifying factors that may enhance (facilitators) or decrease (barriers) engagement in digital cognitive training and possibly modulate its effects are of great clinical relevance. METHODS We measured cognition, symptom severity, motivation (semi-structured interview), and engagement (adapted Utrecht Work Engagement Scale - UWES) of 27 patients with schizophrenia after a 40-h digital cognitive training. The interview transcript quotes were coded and categorized into facilitators and barriers. Thereafter, we tested the association of motivation and engagement with changes in cognition and symptoms after training. RESULTS The facilitator 'good performance' and the barrier 'difficult exercise' were associated with larger gains in attention (p = 0.03) and reasoning and problem solving (p = 0.02), respectively. 'Poor performance' was associated with smaller gains in global cognition (p < 0.01), attention (p = 0.03), and working memory (p = 0.02). The facilitator 'welcoming setting' was associated with larger reductions in the negative (p = 0.01) and total (p = 0.01) symptoms measured by the Positive and Negative Syndrome Scale. The UWES engagement scale was associated with different facilitators and barriers that emerged from the interview, an indication of consistency among both qualitative and quantitative assessments. DISCUSSION Using a mixed quantitative and qualitative research design, we showed associations between motivation and engagement and the response to digital cognitive training in schizophrenia. Facilitators and barriers were associated with engagement, gains in cognition, and reduced symptoms after the intervention, providing insights on how to increase engagement in the digital cognitive training delivered to subjects with schizophrenia.
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Affiliation(s)
- Luana G Mororó
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Anna Luiza Guimarães
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Ana Carolina Costa
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Larissa Genaro
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Maria T Cavalcanti
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - Linda Scoriels
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil; Université Paris Cité, Institut de Psychiatrie et Neurosciences de Paris, Inserm 1266, Paris, France
| | - Rogerio Panizzutti
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil.
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33
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Dabiri M, Dehghani Firouzabadi F, Yang K, Barker PB, Lee RR, Yousem DM. Neuroimaging in schizophrenia: A review article. Front Neurosci 2022; 16:1042814. [PMID: 36458043 PMCID: PMC9706110 DOI: 10.3389/fnins.2022.1042814] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
In this review article we have consolidated the imaging literature of patients with schizophrenia across the full spectrum of modalities in radiology including computed tomography (CT), morphologic magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and magnetoencephalography (MEG). We look at the impact of various subtypes of schizophrenia on imaging findings and the changes that occur with medical and transcranial magnetic stimulation (TMS) therapy. Our goal was a comprehensive multimodality summary of the findings of state-of-the-art imaging in untreated and treated patients with schizophrenia. Clinical imaging in schizophrenia is used to exclude structural lesions which may produce symptoms that may mimic those of patients with schizophrenia. Nonetheless one finds global volume loss in the brains of patients with schizophrenia with associated increased cerebrospinal fluid (CSF) volume and decreased gray matter volume. These features may be influenced by the duration of disease and or medication use. For functional studies, be they fluorodeoxyglucose positron emission tomography (FDG PET), rs-fMRI, task-based fMRI, diffusion tensor imaging (DTI) or MEG there generally is hypoactivation and disconnection between brain regions. However, these findings may vary depending upon the negative or positive symptomatology manifested in the patients. MR spectroscopy generally shows low N-acetylaspartate from neuronal loss and low glutamine (a neuroexcitatory marker) but glutathione may be elevated, particularly in non-treatment responders. The literature in schizophrenia is difficult to evaluate because age, gender, symptomatology, comorbidities, therapy use, disease duration, substance abuse, and coexisting other psychiatric disorders have not been adequately controlled for, even in large studies and meta-analyses.
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Affiliation(s)
- Mona Dabiri
- Department of Radiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kun Yang
- Department of Psychiatry, Molecular Psychiatry Program, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Peter B. Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, United States
| | - Roland R. Lee
- Department of Radiology, UCSD/VA Medical Center, San Diego, CA, United States
| | - David M. Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD, United States
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Onitsuka T, Hirano Y, Nakazawa T, Ichihashi K, Miura K, Inada K, Mitoma R, Yasui-Furukori N, Hashimoto R. Toward recovery in schizophrenia: Current concepts, findings, and future research directions. Psychiatry Clin Neurosci 2022; 76:282-291. [PMID: 35235256 DOI: 10.1111/pcn.13342] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 11/30/2022]
Abstract
Schizophrenia was initially defined as "dementia praecox" by E. Kraepelin, which implies progressive deterioration. However, recent studies have revealed that early effective intervention may lead to social and functional recovery in schizophrenia. In this review, we provide an overview of current concepts in schizophrenia and pathophysiological hypotheses. In addition, we present recent findings from clinical and basic research on schizophrenia. Recent neuroimaging and neurophysiological studies have consistently revealed specific biological differences in the structure and function of the brain in those with schizophrenia. From a basic research perspective, to determine the essential pathophysiology underlying schizophrenia, it is crucial that findings from all lines of inquiry-induced pluripotent stem cell (iPSC)-derived neural cells from patients, murine models expressing genetic mutations identified in patients, and patient clinical data-be integrated to contextualize the analysis results. However, the findings remain insufficient to serve as a diagnostic tool or a biomarker for predicting schizophrenia-related outcomes. Collaborations to conduct clinical research based on the patients' and their families' values are just beginning, and further development is expected.
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Affiliation(s)
- Toshiaki Onitsuka
- Department of Neuroimaging Psychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Takanobu Nakazawa
- Department of Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Kayo Ichihashi
- Department of Neuropsychiatry, The University of Tokyo Hospital, Tokyo, Japan
| | - Kenichiro Miura
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ken Inada
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.,Department of Psychiatry, Kitasato University School of Medicine, Kanagawa, Japan
| | - Ryo Mitoma
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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35
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Deperrois N, Petrovici MA, Senn W, Jordan J. Learning cortical representations through perturbed and adversarial dreaming. eLife 2022; 11:76384. [PMID: 35384841 PMCID: PMC9071267 DOI: 10.7554/elife.76384] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Humans and other animals learn to extract general concepts from sensory experience without extensive teaching. This ability is thought to be facilitated by offline states like sleep where previous experiences are systemically replayed. However, the characteristic creative nature of dreams suggests that learning semantic representations may go beyond merely replaying previous experiences. We support this hypothesis by implementing a cortical architecture inspired by generative adversarial networks (GANs). Learning in our model is organized across three different global brain states mimicking wakefulness, non-rapid eye movement (NREM), and REM sleep, optimizing different, but complementary, objective functions. We train the model on standard datasets of natural images and evaluate the quality of the learned representations. Our results suggest that generating new, virtual sensory inputs via adversarial dreaming during REM sleep is essential for extracting semantic concepts, while replaying episodic memories via perturbed dreaming during NREM sleep improves the robustness of latent representations. The model provides a new computational perspective on sleep states, memory replay, and dreams, and suggests a cortical implementation of GANs.
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Affiliation(s)
| | | | - Walter Senn
- Department of Physiology, University of Bern, Bern, Switzerland
| | - Jakob Jordan
- Department of Physiology, University of Bern, Bern, Switzerland
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36
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Tang H, Riley MR, Singh B, Qi XL, Blake DT, Constantinidis C. Prefrontal cortical plasticity during learning of cognitive tasks. Nat Commun 2022; 13:90. [PMID: 35013248 PMCID: PMC8748623 DOI: 10.1038/s41467-021-27695-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Training in working memory tasks is associated with lasting changes in prefrontal cortical activity. To assess the neural activity changes induced by training, we recorded single units, multi-unit activity (MUA) and local field potentials (LFP) with chronic electrode arrays implanted in the prefrontal cortex of two monkeys, throughout the period they were trained to perform cognitive tasks. Mastering different task phases was associated with distinct changes in neural activity, which included recruitment of larger numbers of neurons, increases or decreases of their firing rate, changes in the correlation structure between neurons, and redistribution of power across LFP frequency bands. In every training phase, changes induced by the actively learned task were also observed in a control task, which remained the same across the training period. Our results reveal how learning to perform cognitive tasks induces plasticity of prefrontal cortical activity, and how activity changes may generalize between tasks.
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Affiliation(s)
- Hua Tang
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
- Center for Neuropsychiatric Diseases, Institute of Life Science, Nanchang University, Nanchang, 330031, Jiangxi, China
- Laboratory of Neuropsychology, National Institutes of Mental Health, NIH, Bethesda, MD, 20892, USA
| | - Mitchell R Riley
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Balbir Singh
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Xue-Lian Qi
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - David T Blake
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA, 30912, USA
| | - Christos Constantinidis
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA.
- Neuroscience Program, Vanderbilt University, Nashville, TN, 37235, USA.
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
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37
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Chung A, Jou C, Grau-Perales A, Levy E, Dvorak D, Hussain N, Fenton AA. Cognitive control persistently enhances hippocampal information processing. Nature 2021; 600:484-488. [PMID: 34759316 PMCID: PMC8872635 DOI: 10.1038/s41586-021-04070-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 09/29/2021] [Indexed: 01/30/2023]
Abstract
Could learning that uses cognitive control to judiciously use relevant information while ignoring distractions generally improve brain function, beyond forming explicit memories? According to a neuroplasticity hypothesis for how some cognitive behavioural therapies are effective, cognitive control training (CCT) changes neural circuit information processing1-3. Here we investigated whether CCT persistently alters hippocampal neural circuit function. We show that mice learned and remembered a conditioned place avoidance during CCT that required ignoring irrelevant locations of shock. CCT facilitated learning new tasks in novel environments for several weeks, relative to unconditioned controls and control mice that avoided the same place during reduced distraction. CCT rapidly changes entorhinal cortex-to-dentate gyrus synaptic circuit function, resulting in an excitatory-inhibitory subcircuit change that persists for months. CCT increases inhibition that attenuates the dentate response to medial entorhinal cortical input, and through disinhibition, potentiates the response to strong inputs, pointing to overall signal-to-noise enhancement. These neurobiological findings support the neuroplasticity hypothesis that, as well as storing item-event associations, CCT persistently optimizes neural circuit information processing.
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Affiliation(s)
- Ain Chung
- Center for Neural Science, New York University
| | - Claudia Jou
- Department of Psychology, Hunter College, City University of New York
| | | | - Eliott Levy
- Center for Neural Science, New York University
| | - Dino Dvorak
- Center for Neural Science, New York University
| | | | - André A. Fenton
- Center for Neural Science, New York University,Neuroscience Institute at the NYU Langone Medical Center
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38
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The Role of the Medial Prefontal Cortex in Self-Agency in Schizophrenia. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6. [PMID: 34761121 PMCID: PMC8577427 DOI: 10.20900/jpbs.20210017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Schizophrenia is a disorder of the self. In particular, patients show cardinal deficits in self-agency (i.e., the experience and awareness of being the agent of one’s own thoughts and actions) that directly contribute to positive psychotic symptoms of hallucinations and delusions and distort reality monitoring (defined as distinguishing self-generated information from externally-derived information). Predictive coding models suggest that the experience of self-agency results from a minimal prediction error between the predicted sensory consequence of a self-generated action and the actual outcome. In other words, the experience of self-agency is thought to be driven by making reliable predictions about the expected outcomes of one’s own actions. Most of the agency literature has focused on the motor system; here we present a novel viewpoint that examines agency from a different lens using distinct tasks of reality monitoring and speech monitoring. The self-prediction mechanism that leads to self-agency is necessary for reality monitoring in that self-predictions represent a critical precursor for the successful encoding and memory retrieval of one’s own thoughts and actions during reality monitoring to enable accurate self-agency judgments (i.e., accurate identification of self-generated information). This self-prediction mechanism is also critical for speech monitoring where we continually compare auditory feedback (i.e., what we hear ourselves say) with what we expect to hear. Prior research has shown that the medial prefrontal cortex (mPFC) may represent one potential neural substrate of this self-prediction mechanism. Unfortunately, patients with schizophrenia (SZ) show mPFC hypoactivity associated with self-agency impairments on reality and speech monitoring tasks, as well as aberrant mPFC functional connectivity during intrinsic measures of agency during resting states that predicted worsening psychotic symptoms. Causal neurostimulation and neurofeedback techniques can move the frontiers of schizophrenia research into a new era where we implement techniques to manipulate excitability in key neural regions, such as the mPFC, to modulate patients’ reliance on self-prediction mechanisms on distinct tasks of reality and speech monitoring. We hypothesize these findings will show that mPFC provides a unitary basis for self-agency, driven by reliance on self-prediction mechanisms, which will facilitate the development of new targeted treatments in patients with schizophrenia.
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39
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Jack BN, Chilver MR, Vickery RM, Birznieks I, Krstanoska-Blazeska K, Whitford TJ, Griffiths O. Movement Planning Determines Sensory Suppression: An Event-related Potential Study. J Cogn Neurosci 2021; 33:2427-2439. [PMID: 34424986 DOI: 10.1162/jocn_a_01747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Sensory suppression refers to the phenomenon that sensory input generated by our own actions, such as moving a finger to press a button to hear a tone, elicits smaller neural responses than sensory input generated by external agents. This observation is usually explained via the internal forward model in which an efference copy of the motor command is used to compute a corollary discharge, which acts to suppress sensory input. However, because moving a finger to press a button is accompanied by neural processes involved in preparing and performing the action, it is unclear whether sensory suppression is the result of movement planning, movement execution, or both. To investigate this, in two experiments, we compared ERPs to self-generated tones that were produced by voluntary, semivoluntary, or involuntary button-presses, with externally generated tones that were produced by a computer. In Experiment 1, the semivoluntary and involuntary button-presses were initiated by the participant or experimenter, respectively, by electrically stimulating the median nerve in the participant's forearm, and in Experiment 2, by applying manual force to the participant's finger. We found that tones produced by voluntary button-presses elicited a smaller N1 component of the ERP than externally generated tones. This is known as N1-suppression. However, tones produced by semivoluntary and involuntary button-presses did not yield significant N1-suppression. We also found that the magnitude of N1-suppression linearly decreased across the voluntary, semivoluntary, and involuntary conditions. These results suggest that movement planning is a necessary condition for producing sensory suppression. We conclude that the most parsimonious account of sensory suppression is the internal forward model.
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Affiliation(s)
- Bradley N Jack
- University of New South Wales Sydney, Australia.,Australian National University, Canberra
| | - Miranda R Chilver
- University of New South Wales Sydney, Australia.,Neuroscience Research Australia, Sydney
| | - Richard M Vickery
- University of New South Wales Sydney, Australia.,Neuroscience Research Australia, Sydney
| | - Ingvars Birznieks
- University of New South Wales Sydney, Australia.,Neuroscience Research Australia, Sydney
| | | | | | - Oren Griffiths
- University of New South Wales Sydney, Australia.,Flinders University, Adelaide, Australia
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40
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Abstract
Working memory (WM) is the ability to maintain and manipulate information in the conscious mind over a timescale of seconds. This ability is thought to be maintained through the persistent discharges of neurons in a network of brain areas centered on the prefrontal cortex, as evidenced by neurophysiological recordings in nonhuman primates, though both the localization and the neural basis of WM has been a matter of debate in recent years. Neural correlates of WM are evident in species other than primates, including rodents and corvids. A specialized network of excitatory and inhibitory neurons, aided by neuromodulatory influences of dopamine, is critical for the maintenance of neuronal activity. Limitations in WM capacity and duration, as well as its enhancement during development, can be attributed to properties of neural activity and circuits. Changes in these factors can be observed through training-induced improvements and in pathological impairments. WM thus provides a prototypical cognitive function whose properties can be tied to the spiking activity of brain neurons. © 2021 American Physiological Society. Compr Physiol 11:1-41, 2021.
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Affiliation(s)
- Russell J Jaffe
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Christos Constantinidis
- Department of Neurobiology & Anatomy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Neuroscience Program, Vanderbilt University, Nashville, Tennessee, USA
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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41
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Neural Correlates of Aberrant Salience and Source Monitoring in Schizophrenia and At-Risk Mental States-A Systematic Review of fMRI Studies. J Clin Med 2021; 10:jcm10184126. [PMID: 34575237 PMCID: PMC8468329 DOI: 10.3390/jcm10184126] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/22/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023] Open
Abstract
Cognitive biases are an important factor contributing to the development and symptom severity of psychosis. Despite the fact that various cognitive biases are contributing to psychosis, they are rarely investigated together. In the current systematic review, we aimed at investigating specific and shared functional neural correlates of two important cognitive biases: aberrant salience and source monitoring. We conducted a systematic search of fMRI studies of said cognitive biases. Eight studies on aberrant salience and eleven studies on source monitoring were included in the review. We critically discussed behavioural and neuroimaging findings concerning cognitive biases. Various brain regions are associated with aberrant salience and source monitoring in individuals with schizophrenia and the risk of psychosis. The ventral striatum and insula contribute to aberrant salience. The medial prefrontal cortex, superior and middle temporal gyrus contribute to source monitoring. The anterior cingulate cortex and hippocampus contribute to both cognitive biases, constituting a neural overlap. Our review indicates that aberrant salience and source monitoring may share neural mechanisms, suggesting their joint role in producing disrupted external attributions of perceptual and cognitive experiences, thus elucidating their role in positive symptoms of psychosis. Account bridging mechanisms of these two biases is discussed. Further studies are warranted.
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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: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [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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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 SCHIZOPHRENIA 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] [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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Kutafina E, Heiligers A, Popovic R, Brenner A, Hankammer B, Jonas SM, Mathiak K, Zweerings J. Tracking of Mental Workload with a Mobile EEG Sensor. SENSORS 2021; 21:s21155205. [PMID: 34372445 PMCID: PMC8348794 DOI: 10.3390/s21155205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 12/04/2022]
Abstract
The aim of the present investigation was to assess if a mobile electroencephalography (EEG) setup can be used to track mental workload, which is an important aspect of learning performance and motivation and may thus represent a valuable source of information in the evaluation of cognitive training approaches. Twenty five healthy subjects performed a three-level N-back test using a fully mobile setup including tablet-based presentation of the task and EEG data collection with a self-mounted mobile EEG device at two assessment time points. A two-fold analysis approach was chosen including a standard analysis of variance and an artificial neural network to distinguish the levels of cognitive load. Our findings indicate that the setup is feasible for detecting changes in cognitive load, as reflected by alterations across lobes in different frequency bands. In particular, we observed a decrease of occipital alpha and an increase in frontal, parietal and occipital theta with increasing cognitive load. The most distinct levels of cognitive load could be discriminated by the integrated machine learning models with an accuracy of 86%.
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Affiliation(s)
- Ekaterina Kutafina
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (R.P.); (B.H.)
- Faculty of Applied Mathematics, AGH University of Science and Technology, 30-059 Krakow, Poland
- Correspondence:
| | - Anne Heiligers
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (A.H.); (K.M.); (J.Z.)
| | - Radomir Popovic
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (R.P.); (B.H.)
| | - Alexander Brenner
- Institute of Medical Informatics, University of Münster, 48149 Münster, Germany;
| | - Bernd Hankammer
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; (R.P.); (B.H.)
| | - Stephan M. Jonas
- Department of Informatics, Technical University of Munich, 85748 Garching, Germany;
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (A.H.); (K.M.); (J.Z.)
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (A.H.); (K.M.); (J.Z.)
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Emergence of Nonlinear Mixed Selectivity in Prefrontal Cortex after Training. J Neurosci 2021; 41:7420-7434. [PMID: 34301827 DOI: 10.1523/jneurosci.2814-20.2021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/23/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022] Open
Abstract
Neurons in the PFC are typically activated by different cognitive tasks, and also by different stimuli and abstract variables within these tasks. A single neuron's selectivity for a given stimulus dimension often changes depending on its context, a phenomenon known as nonlinear mixed selectivity (NMS). It has previously been hypothesized that NMS emerges as a result of training to perform tasks in different contexts. We tested this hypothesis directly by examining the neuronal responses of different PFC areas before and after male monkeys were trained to perform different working memory tasks involving visual stimulus locations and/or shapes. We found that training induces a modest increase in the proportion of PFC neurons with NMS exclusively for spatial working memory, but not for shape working memory tasks, with area 9/46 undergoing the most significant increase in NMS cell proportion. We also found that increased working memory task complexity, in the form of simultaneously storing location and shape combinations, does not increase the degree of NMS for stimulus shape with other task variables. Lastly, in contrast to the previous studies, we did not find evidence that NMS is predictive of task performance. Our results thus provide critical insights on the representation of stimuli and task information in neuronal populations, in working memory.SIGNIFICANCE STATEMENT How multiple types of information are represented in working memory remains a complex computational problem. It has been hypothesized that nonlinear mixed selectivity allows neurons to efficiently encode multiple stimuli in different contexts, after subjects have been trained in complex tasks. Our analysis of prefrontal recordings obtained before and after training monkeys to perform working memory tasks only partially agreed with this prediction, in that nonlinear mixed selectivity emerged for spatial but not shape information, and mostly in mid-dorsal PFC. Nonlinear mixed selectivity also displayed little modulation across either task complexity or correct performance. These results point to other mechanisms, in addition to nonlinear mixed selectivity, representing complex information about stimulus and task context in neuronal activity.
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Echiverri-Cohen A, Spierer L, Perez M, Kulon M, Ellis MD, Craske M. Randomized-controlled trial of response inhibition training for individuals with PTSD and impaired response inhibition. Behav Res Ther 2021; 143:103885. [PMID: 34089923 DOI: 10.1016/j.brat.2021.103885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/04/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
Deficits in response inhibition, defined as an inability to stop a behavior that is no longer relevant, are characteristic of posttraumatic stress disorder (PTSD). Given that impaired response inhibition is associated with worse symptom recovery and accumulating evidence pointing to the effectiveness of cognitive control trainings in reducing PTSD symptoms, individuals with moderate to severe PTSD total severity (Posttraumatic Diagnostic Scale total score ≥ 21) and pre-training response inhibition deficits (M ≤ 75% successful inhibition on the Go/No-go) completed a 3-h, adaptive Go/No-go training designed to improve ability to withhold prepotent motor responses. Then forty-nine participants were randomized to an adaptive response inhibition training (n = 24, M = 19.27 years, SD = 0.70) or a waitlist condition (n = 25, M = 18.31 years, SD = 4.80). Behavioral response inhibition and self-reported trauma-related symptoms were assessed at pre- and post-training. Response inhibition training was associated with improved response inhibition on an untrained transfer Stop-Signal task and symptom reduction in PTSD compared to a waitlist group, at post-training. There was, however, reduced inhibition on a modified Go/No-go task from pre-to post-training. Overall, response inhibition deficits and PTSD symptoms are amenable to top-down remediation using response inhibition training. Our study provides preliminary evidence for the feasibility of response inhibition training in a PTSD sample characterized by response inhibition deficits.
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Affiliation(s)
| | - Lucas Spierer
- Neurology Unit, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Switzerland
| | - Marcelina Perez
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Melissa Kulon
- Department of Psychology, University of California, Los Angeles, CA, USA
| | | | - Michelle Craske
- Department of Psychology, University of California, Los Angeles, CA, USA
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Haas SS, Antonucci LA, Wenzel J, Ruef A, Biagianti B, Paolini M, Rauchmann BS, Weiske J, Kambeitz J, Borgwardt S, Brambilla P, Meisenzahl E, Salokangas RKR, Upthegrove R, Wood SJ, Koutsouleris N, Kambeitz-Ilankovic L. A multivariate neuromonitoring approach to neuroplasticity-based computerized cognitive training in recent onset psychosis. Neuropsychopharmacology 2021; 46:828-835. [PMID: 33027802 PMCID: PMC8027389 DOI: 10.1038/s41386-020-00877-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023]
Abstract
Two decades of studies suggest that computerized cognitive training (CCT) has an effect on cognitive improvement and the restoration of brain activity. Nevertheless, individual response to CCT remains heterogenous, and the predictive potential of neuroimaging in gauging response to CCT remains unknown. We employed multivariate pattern analysis (MVPA) on whole-brain resting-state functional connectivity (rsFC) to (neuro)monitor clinical outcome defined as psychosis-likeness change after 10-hours of CCT in recent onset psychosis (ROP) patients. Additionally, we investigated if sensory processing (SP) change during CCT is associated with individual psychosis-likeness change and cognitive gains after CCT. 26 ROP patients were divided into maintainers and improvers based on their SP change during CCT. A support vector machine (SVM) classifier separating 56 healthy controls (HC) from 35 ROP patients using rsFC (balanced accuracy of 65.5%, P < 0.01) was built in an independent sample to create a naturalistic model representing the HC-ROP hyperplane. This model was out-of-sample cross-validated in the ROP patients from the CCT trial to assess associations between rsFC pattern change, cognitive gains and SP during CCT. Patients with intact SP threshold at baseline showed improved attention despite psychosis status on the SVM hyperplane at follow-up (p < 0.05). Contrarily, the attentional gains occurred in the ROP patients who showed impaired SP at baseline only if rsfMRI diagnosis status shifted to the healthy-like side of the SVM continuum. Our results reveal the utility of MVPA for elucidating treatment response neuromarkers based on rsFC-SP change and pave the road to more personalized interventions.
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Affiliation(s)
- Shalaila S. Haas
- grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Linda A. Antonucci
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany ,grid.7644.10000 0001 0120 3326Department of Education, Psychology, Communication – University of Bari “Aldo Moro”, Bari, Italy
| | - Julian Wenzel
- grid.6190.e0000 0000 8580 3777University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Anne Ruef
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Bruno Biagianti
- grid.438587.50000 0004 0450 1574Department of R&D, Posit Science Corporation, San Francisco, CA USA ,grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Marco Paolini
- Department of Radiology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Boris-Stephan Rauchmann
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany ,Department of Radiology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Johanna Weiske
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Joseph Kambeitz
- grid.6190.e0000 0000 8580 3777University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Stefan Borgwardt
- grid.4562.50000 0001 0057 2672Translational Psychiatry Unit (TPU), Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Paolo Brambilla
- grid.414818.00000 0004 1757 8749Department of Neuroscience and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Mental Health, University of Milan, Milan, Italy
| | - Eva Meisenzahl
- grid.411327.20000 0001 2176 9917Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Raimo K. R. Salokangas
- grid.1374.10000 0001 2097 1371Department of Psychiatry, University of Turku, Turku, Finland
| | - Rachel Upthegrove
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Birmingham, United Kingdom ,grid.6572.60000 0004 1936 7486Institute of Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Stephen J. Wood
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Birmingham, United Kingdom ,grid.488501.0Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, University of Melbourne, Melbourne, VIC Australia
| | - Nikolaos Koutsouleris
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany. .,University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
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Abstract
BACKGROUND Commercial video games are a vastly popular form of recreational activity. Whilst concerns persist regarding possible negative effects of video games, they have been suggested to provide cognitive benefits to users. They are also frequently employed as control interventions in comparisons of more complex cognitive or psychological interventions. If independently effective, video games - being both engaging and relatively inexpensive - could provide a much more cost-effective add-on intervention to standard treatment when compared to costly, cognitive interventions. OBJECTIVES To review the effects of video games (alone or as an additional intervention) compared to standard care alone or other interventions including, but not limited to, cognitive remediation or cognitive behavioural therapy for people with schizophrenia or schizophrenia-like illnesses. SEARCH METHODS We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (March 2017, August 2018, August 2019). SELECTION CRITERIA Randomised controlled trials focusing on video games for people with schizophrenia or schizophrenia-like illnesses. DATA COLLECTION AND ANALYSIS Review authors extracted data independently. For binary outcomes we calculated risk ratio (RR) with its 95% confidence interval (CI) on an intention-to-treat basis. For continuous data we calculated the mean difference (MD) between groups and its CI. We employed a fixed-effect model for analyses. We assessed risk of bias for the included studies and created a 'Summary of findings' table using GRADE. MAIN RESULTS This review includes seven trials conducted between 2009 and 2018 (total = 468 participants, range 32 to 121). Study duration varied from six weeks to twelve weeks. All interventions in the included trials were given in addition to standard care, including prescribed medication. In trials video games tend to be the control for testing efficacy of complex, cognitive therapies; only two small trials evaluated commercial video games as the intervention. We categorised video game interventions into 'non-exergame' (played statically) and 'exergame' (the players use bodily movements to control the game). Our main outcomes of interest were clinically important changes in: general functioning, cognitive functioning, social functioning, mental state, quality of life, and physical fitness as well as clinically important adverse effects. We found no clear difference between non-exergames and cognitive remediation in general functioning scores (Strauss Carpenter Outcome Scale) (MD 0.42, 95% CI -0.62 to 1.46; participants = 86; studies = 1, very low-quality evidence) or social functioning scores (Specific Levels of Functioning Scale) (MD -3.13, 95% CI -40.17 to 33.91; participants = 53; studies = 1, very low-quality evidence). There was a clear difference favouring cognitive remediation for cognitive functioning (improved on at least one domain of MATRICS Consensus Cognitive Battery Test) (RR 0.58, 95% CI 0.34 to 0.99; participants = 42; studies = 1, low-quality evidence). For mental state, Positive and Negative Syndrome Scale (PANSS) overall scores showed no clear difference between treatment groups (MD 0.20, 95% CI -3.89 to 4.28; participants = 269; studies = 4, low-quality evidence). Quality of life ratings (Quality of Life Scale) similarly showed no clear intergroup difference (MD 0.01, 95% CI -0.40 to 0.42; participants = 87; studies = 1, very low-quality evidence). Adverse effects were not reported; we chose leaving the study early as a proxy measure. The attrition rate by end of treatment was similar between treatment groups (RR 0.96, 95% CI 0.87 to 1.06; participants = 395; studies = 5, low-quality evidence). One small trial compared exergames with standard care, but few outcomes were reported. No clear difference between interventions was seen for cognitive functioning (measured by MATRICS Consensus Cognitive Battery Test) (MD 2.90, 95% CI -1.27 to 7.07; participants = 33; studies = 1, low-quality evidence), however a benefit in favour of exergames was found for average change in physical fitness (aerobic fitness) (MD 3.82, 95% CI 1.75 to 5.89; participants = 33; studies = 1, low-quality evidence). Adverse effects were not reported; we chose leaving the study early as a proxy measure. The attrition rate by end of treatment was similar between treatment groups (RR 1.06, 95% CI 0.75 to 1.51; participants = 33; studies = 1). Another small trial compared exergames with non-exergames. Only one of our main outcomes was reported - physical fitness, which was measured by average time taken to walk 3 metres. No clear intergroup difference was identified at six-week follow-up (MD -0.50, 95% CI -1.17 to 0.17; participants = 28; studies = 1, very low-quality evidence). No trials reported adverse effects. We chose leaving the study early as a proxy outcome. AUTHORS' CONCLUSIONS Our results suggest that non-exergames may have a less beneficial effect on cognitive functioning than cognitive remediation, but have comparable effects for all other outcomes. These data are from a small number of trials, and the evidence is graded as of low or very low quality and is very likely to change with more data. It is difficult to currently establish if the more sophisticated cognitive approaches do any more good - or harm - than 'static' video games for people with schizophrenia. Where players use bodily movements to control the game (exergames), there is very limited evidence suggesting a possible benefit of exergames compared to standard care in terms of cognitive functioning and aerobic fitness. However, this finding must be replicated in trials with a larger sample size and that are conducted over a longer time frame. We cannot draw any firm conclusions regarding the effects of video games until more high-quality evidence is available. There are ongoing studies that may provide helpful data in the near future.
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Affiliation(s)
| | - Jack Lloyd
- University of West London, London Ambulance Service NHS Trust, London, UK
| | - Maritta Välimäki
- Xiangya Nursing School, Central South University, Xiangya, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Grace Wk Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Megan Freemantle
- Department of Medicine, Hull York Medical School, University of Hull, Hull, UK
| | - Anna Zsófia Békefi
- Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary
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van der Stouwe ECD, Pijnenborg GHM, Opmeer EM, de Vries B, Marsman JBC, Aleman A, van Busschbach JT. Neural changes following a body-oriented resilience therapy with elements of kickboxing for individuals with a psychotic disorder: a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci 2021; 271:355-366. [PMID: 31980899 PMCID: PMC7960594 DOI: 10.1007/s00406-020-01097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/13/2020] [Indexed: 11/27/2022]
Abstract
Individuals with a psychotic disorder are at an increased risk of becoming the victim of a crime. A body-oriented resilience therapy (BEATVIC) aimed at preventing victimization by addressing putatively underlying factors was developed. One of these factors is social cognition, particularly facial affect processing. The current study investigated neural effects of BEATVIC on facial affect processing using two face processing tasks. Participants were randomized to either BEATVIC or a 'Befriending' control group. Twenty-seven patients completed an Emotional Faces task and the Wall of Faces task during fMRI, pre- and post-intervention. General linear model analyses yielded no differences between groups over time. Independent component analyses revealed increased activation of the salience network to angry and fearful faces in BEATVIC compared to Befriending. Increased activation of the salience network may suggest an increased alertness for potentially dangerous faces.
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Affiliation(s)
- Elisabeth C D van der Stouwe
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands.
| | - Gerdina H M Pijnenborg
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Department of Psychotic Disorders, GGZ-Drenthe, Dennenweg 9, 9404 LA, Assen, The Netherlands
| | - Esther M Opmeer
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
- Department of Health and Social Work, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA, Zwolle, The Netherlands
| | - Bertine de Vries
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Jan-Bernard C Marsman
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
| | - André Aleman
- Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
- Department of Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Jooske T van Busschbach
- University of Groningen, University Medical Center Groningen, University Center of Psychiatry, Rob Giel Onderzoekcentrum, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA, Zwolle, The Netherlands
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50
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Humpston C, Garrison J, Orlov N, Aleman A, Jardri R, Fernyhough C, Allen P. Real-Time Functional Magnetic Resonance Imaging Neurofeedback for the Relief of Distressing Auditory-Verbal Hallucinations: Methodological and Empirical Advances. Schizophr Bull 2020; 46:1409-1417. [PMID: 32740661 PMCID: PMC7707074 DOI: 10.1093/schbul/sbaa103] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Auditory-verbal hallucinations (AVH) are often associated with high levels of distress and disability in individuals with schizophrenia-spectrum disorders. In around 30% of individuals with distressing AVH and diagnosed with schizophrenia, traditional antipsychotic drugs have little or no effect. Thus, it is important to develop mechanistic models of AVH to inform new treatments. Recently a small number of studies have begun to explore the use of real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) for the treatment of AVH in individuals with schizophrenia. rtfMRI-NF protocols have been developed to provide feedback about brain activation in real time to enable participants to progressively achieve voluntary control over their brain activity. We offer a conceptual review of the background and general features of neurofeedback procedures before summarizing and evaluating existing mechanistic models of AVH to identify feasible neural targets for the application of rtfMRI-NF as a potential treatment. We consider methodological issues, including the choice of localizers and practicalities in logistics when setting up neurofeedback procedures in a clinical setting. We discuss clinical considerations relating to the use of rtfMRI-NF for AVH in individuals distressed by their experiences and put forward a number of questions and recommendations about best practice. Lastly, we conclude by offering suggestions for new avenues for neurofeedback methodology and mechanistic targets in relation to the research and treatment of AVH.
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Affiliation(s)
- Clara Humpston
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK,Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,To whom correspondence should be addressed; tel: +44 (0)121 414 2942, fax: +44 (0)121 414 3971, e-mail:
| | - Jane Garrison
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Natasza Orlov
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA,Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China,Precision Brain Imaging Lab, Medical University of South Carolina, Charleston, SC
| | - André Aleman
- Faculty of Medical Sciences, University of Groningen, AB Groningen, The Netherlands
| | - Renaud Jardri
- University of Lille, INSERM, CHU Lille, Lille Neuroscience and Cognition Centre (U-1172), Plasticity and Subjectivity (PSY) Team, CURE Platform, Lille, France
| | | | - Paul Allen
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Department of Psychology, University of Roehampton, London, UK
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