DOCSLIB.ORG

Hypofrontality in Men with First-Episode Psychosis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Hypofrontality in Men with First-Episode Psychosis BRITISH JOURNAL OF PSYCHIATRY (2005), 186, 203^208 Hypofrontality in men with first-episode psychosis protocol, patients must have presented with first-episode psychosis with symptoms lasting more than 1 week, not attributable V. MOLINA, J. SANZ, S. REIG, R. MARTIMARTINEZ,¤NEZ, F. SARRAMEA, R. LUQUE, to organic or toxic origin, and unrelated C.BENITO,J.D.GISPERT,J.PASCAUandM.DESCOC. BENITO, J. D.GISPERT, J. PASCAU and M. DESCO to any other Axis I disorder; the presence ofofanyany relevant stressors clearly related to the episode had to be ruled out. We usedusedthesethese criteria in order to avoid recruitingrecruitingpatientspatients with transient psychotic symptoms,symptoms,according to DSM–IV criteria (American Psychiatric Association, 1994).1994). Background Decreased metabolic Decreased metabolic activity in the prefron- After inclusion, all patients were activity in the prefrontal cortex during tal cortex during cognitive activation is a followed for 2 years on an out-patient basis recurrent finding in schizophrenia (Volz with monthly visits, to confirm or rule out a cognitive activation is a recurrent finding et aletal, 1999). If it were not present in other diagnosis of schizophrenia at the end of this and a likely functionalfunctionalmarker marker of psychotic disorders, hypofrontality could period. After this follow-up, two experi- schizophrenia. constitute a distinctive marker for schizo- enced psychiatrists (V.M. and J.S.), masked phrenia. Although other groups have to the results of the PET scans, diagnosed Aims Toinvestigate the occurrence of published data on hypofrontality in schizo- each patient and decided whether the index hypofrontalityin patients with first- phreniform disorders (Andreasen et aletal,, episode was a first break of schizophrenia episode psychosis, with or without 1997), we know of none comparing meta- or, instead, a single psychotic episode that evolution to schizophrenia. bolic patterns in these patients in the light did not evolve into schizophrenia 2 years of whether or not they progress to schizo- after the enrolment. For this final diagnosis MethodMethod Weused fluorodeoxyglucose phrenia. To confirm hypofrontality as a they used all the available follow-up feature typical of schizophrenia, it would information (including total duration of positron emission tomography during the be advisable to study patients in very early significantsignificantsymptoms),symptoms), a semi-structured in- performance of an attentiontask and stages of the disease. This design requires terview, the Structured Clinical Interview magnetic resonance imaging to study the a corroboration of the diagnosis of schizo- for DSM–IVAccess I Disorders – Clinician dorsolateral prefrontal region in13 men phrenia by a prospective follow-up. With Version (SCID–CV; First et aletal, 1997) and with a first episode of psychosis.Data from this goal, we used magnetic resonance the information provided by the families imaging (MRI) and [1818F]fluorodeoxyglu- and clinical personnel. For diagnostic patients who progressed to schizophrenia cose (FDG) positron emission tomography purposes, the duration of symptoms was were compared withthose of patients (PET) to investigate two groups of people calculated covering the period before and who did not meet criteria for this diagnosis with first-episode psychosis: one group in after initiation of treatment. after 2 years. which the diagnosis of schizophrenia was On the basis of their final diagnosis, the confirmed 2 years later, and a group who 13 patients were divided into two groups. ResultsResults Patients who developed did not meet the criteria for this diagnosis The schizophrenia group comprised six schizophrenia demonstrated a significant after the same period. people with a diagnosis of paranoid schizo-schizo- phrenia according to DSM–IV criteria. TheThe hypofrontalityinthehypofrontality in the dorsolateral non-schizophrenia group comprised six prefrontal cortex in comparison with the METHOD people with a diagnosis of schizophreni- non-schizophrenia and control groups. form psychosis and one person who had Study participants experienced a brief psychotic disorder (with Conclusions Our results suggestthat The existence of gender-related differences a symptom duration of 3 weeks), likewise hypofrontalitycouldhypofrontality could be a marker of in frontal activity cannot be ruled out, con- according to DSM–IV criteria. The latter di- schizophrenia atthe time oftheof the first sidering that structural alterations seem to agnoses meant that these patients’ psychotic psychotic episode, in agreement with be more pronounced in men (Nopoulos episodesepisodeswere shorter than required to qua- et aletal, 1997). For this reason, and to achieve lify as schizophrenia, no other psychotic neurodevelopmental theories of maximum sample homogeneity, our study episode occurred during follow-up and the schizophrenia. was limited to men. Thirteen right-handed patients did not meet schizophrenia criteria men with a first psychotic episode were (including enduring negative symptoms) at Declaration of interest None.None. enrolled in a diachronic study of first-break the end of follow-up. The duration of the Funding detailed in Acknowledgements. schizophrenia; all of them were enrolled disease in the non-schizophrenia group while hospitalised for the first time in the was less than 3 months in all cases. The psychiatric unit of a general hospital. The clinical scores calculated using the Positive PET and MRI scans were performed at and Negative Syndrome Scale (PANSS; the time of inclusion in the study, before KayKay et aletal, 1992) at the time of admission any of the patients had met the criteria and at the end of follow-up are shown in for schizophrenia. To be included in the Table 1.Table1. 203 Downloaded from https://www.cambridge.org/core. 27 Sep 2021 at 21:32:17, subject to the Cambridge Core terms of use. MOLINA ET AL Ta b l e 1 Demographic and clinical characteristics of participants regional metabolic activity in the PET image (Molina et aletal, 2003).,2003). Schizophrenia Non-schizophrenia Control group (nn¼6) group ((group nn¼7) group ((group nn¼8)8) MRI protocol Mean (s.d.) Mean (s.d.) Mean (s.d.) Magnetic resonance images were acquired on a Philips Gyroscan 1.5 T scanner (Philips Age, years 24.2 (4.4) 29.1 (8.8)(8.8)29.1 28.7 (6.0)(6.0)28.7 Medical Systems, Reigate, UK) using a TT11-- Education, years 11.5 (4.6)10.9 (6.0)11.8 (4.9) weighted three-dimensional gradient echo Duration of disease, months before inclusion1.1(0.8) 1.1 (0.8) 0.9 0.9(0.6) (0.6) sequence with the following parameters: Parental socio-economic level 2.1 (1.8)2.2 (1.8)2.0 (1.6) matrix size 25666256, pixel size 0.9 mm66 PANSS score 0.9 mm (field of view approximately Positive symptoms 25625666256 mm), flip angle 3088, echo time Enrolment 19.9 (5.1)20.3 (6.1) 4.6 ms, slice thickness 1.1–1.5 mm. In addi- Follow-up 10.0 (3.4)7.2 (2.3) tion,tion, TT22-weighted sequences were acquired Negative symptoms for tissue segmentation and for other clini- Enrolment 15.6 (6.3)12.9 (7.5) cal purposes (turbo spin echo, turbo factor 15, echo time 120 ms, matrix size Follow-up 20.6 (8.3)7.4 (4.1) 25625666256, slice thickness 5.5 mm). General symptoms Enrolment 33.4 (7.1) 30.5 (8.8)(8.8)30.5 Follow-up 30.1 (9.5)(9.5)30.1 17.4 (7.7) PET protocolprotocolPET The PET study used a Siemens Exact 47 PANSS, Positive and Negative Syndrome Scale. tomograph (Siemens, Erlangen, Germany). Scans were obtained 20 min after injecting All patients were antipsychotic-naıantipsychotic-naıve¨ve after completing the treatment). The period 370 MBq of [1818F]FDG, while the partici- prior to the presenting episode; they were of complete remission of these symptoms pant performed a contingent continuous treated solely during the 2 days prior to was greater than 1 year in all cases. performance test (Rosvold et aletal, 1956).,1956). the PET scan. This was a practical means Eight healthy men were also recruited Participants were instructed to push a button of enrolling a sample representative of the as a control reference group. To match if a letter T immediately followed the letter usual presentation of schizophrenia, avoid- them with the patient group, none had an L, presented on a computer screen. The ing a selection bias related to the impaired education to college level. No difference interstimulus interval was 1 s. During the ability of patients with acute psychosis to in age or parental socio-economic level PET scan a neuropsychologist supervised cooperate during neuroimaging procedures. (Hollingshead & Frederick, 1953) was the appropriate response and full compli- All patients received the same treatment observed between the groups (Table 1). ance with the performance test of all parti- (haloperidol 10 mg per day liquid formula- Exclusion criteria for patients and con- cipants. After an intravenous line had been tion) and the medication was discontinued trols were learning disability, neurological inserted for FDG administration, the parti- for 12 h prior to the PET scan. No other disease, MRI findings deemed clinically cipant began the task, which was divided treatment was administered before scan- relevant (from a neurological perspective) into four blocks of 5 min each, with a ning. One patient from the schizophrenia by a radiologist masked to the diagnosis, 1 min rest between blocks; FDG was group and two from the non-schizophrenia history of head trauma with loss of con- administered 1 min after initiating the task. group had received benzodiazepines for sciousness, and history of substance misuse Participants were instructed to fast for at insomnia before inclusion, but they had during the past 6 months (other than occa- least 6 h before the scan, with particular iscontinuediscontinuedthisthis medication for more than sional hypnotics). A urinalysis was done in emphasis on avoiding coffee and other 2 weeks.
Load more

Recommended publications
  • Executive Function and the Frontal Lobes: a Meta-Analytic Review
    Neuropsychology Review, Vol. 16, No. 1, March 2006 (C 2006) DOI: 10.1007/s11065-006-9002-x Executive Function and the Frontal Lobes: A Meta-Analytic Review Julie A. Alvarez1 and Eugene Emory2 Published online: 1 June 2006 Currently, there is debate among scholars regarding how to operationalize and measure executive functions. These functions generally are referred to as “supervisory” cognitive processes because they involve higher level organization and execution of complex thoughts and behavior. Although conceptualizations vary regarding what mental processes actually constitute the “executive function” construct, there has been a historical linkage of these “higher-level” processes with the frontal lobes. In fact, many investigators have used the term “frontal functions” synonymously with “executive functions” despite evidence that contradicts this synonymous usage. The current review provides a critical analysis of lesion and neuroimaging studies using three popular executive function measures (Wisconsin Card Sorting Test, Phonemic Verbal Fluency, and Stroop Color Word Interference Test) in order to examine the validity of the executive function construct in terms of its relation to activation and damage to the frontal lobes. Empirical lesion data are examined via meta-analysis procedures along with formula derivatives. Results reveal mixed evidence that does not support a one-to-one relationship between executive functions and frontal lobe activity. The paper concludes with a discussion of the implications of construing the validity of these neuropsychological tests in anatomical, rather than cognitive and behavioral, terms. KEY WORDS: Executive function; Frontal lobe; Neuropsychology; Meta-analysis. Executive functions generally refer to “higher-level” ropsychological processes involving (a) cognitive flexi- cognitive functions involved in the control and regulation bility, (b) problem-solving, and (c) response maintenance of “lower-level” cognitive processes and goal-directed, (Greve et al., 2002).
    [Show full text]
  • Quantitative Brain Magnetic Resonance Imaging in Girls with Attention-Deficit/Hyperactivity Disorder
    ORIGINAL ARTICLE Quantitative Brain Magnetic Resonance Imaging in Girls With Attention-Deficit/Hyperactivity Disorder F. Xavier Castellanos, MD; Jay N. Giedd, MD; Patrick C. Berquin, MD; James M. Walter, MA; Wendy Sharp, MSW; Thanhlan Tran, BS; A. Catherine Vaituzis; Jonathan D. Blumenthal, MA; Jean Nelson, MHS; Theresa M. Bastain, BA; Alex Zijdenbos, PhD; Alan C. Evans, PhD; Judith L. Rapoport, MD Background: Anatomic studies of boys with attention- Results: Total brain volume was smaller in girls with ADHD deficit/hyperactivity disorder (ADHD) have detected de- than in control subjects (effect size, 0.40; P=.05). As in our creased volumes in total and frontal brain, basal gan- previous study in boys with ADHD, girls with ADHD had glia, and cerebellar vermis. We tested these findings in a significantly smaller volumes in the posterior-inferior cer- sample of girls with ADHD. ebellar vermis (lobules VIII-X; effect size, 0.54; P=.04), even when adjusted for total cerebral volume and vocabulary Methods: Anatomic brain magnetic resonance images score. Patients and controls did not differ in asymmetry in from 50 girls with ADHD, of severity comparable with any region. Morphometric differences correlated signifi- that in previously studied boys, and 50 healthy female cantly with several ratings of ADHD severity and were not control subjects, aged 5 to 15 years, were obtained with predicted by past or present stimulant drug exposure. a 1.5-T scanner with contiguous 2-mm coronal slices and 1.5-mm axial slices. We measured volumes of total ce- Conclusions: These results confirm previous findings rebrum, frontal lobes, caudate nucleus, globus pallidus, for boys in the posterior-inferior lobules of the cerebel- cerebellum, and cerebellar vermis.
    [Show full text]
  • Magnetic Resonance Imaging of Mediodorsal, Pulvinar, and Centromedian Nuclei of the Thalamus in Patients with Schizophrenia
    ORIGINAL ARTICLE Magnetic Resonance Imaging of Mediodorsal, Pulvinar, and Centromedian Nuclei of the Thalamus in Patients With Schizophrenia Eileen M. Kemether, MD; Monte S. Buchsbaum, MD; William Byne, MD, PhD; Erin A. Hazlett, PhD; Mehmet Haznedar, MD; Adam M. Brickman, MPhil; Jimcy Platholi, MA; Rachel Bloom Background: Postmortem and magnetic resonance im- reduced in all 3 nuclei; differences in relative reduction aging (MRI) data have suggested volume reductions in did not differ among the nuclei. The remainder of the the mediodorsal (MDN) and pulvinar nuclei (PUL) of the thalamic volume (whole thalamus minus the volume of thalamus. The centromedian nucleus (CMN), impor- the 3 delineated nuclei) was not different between schizo- tant in attention and arousal, has not been previously stud- phrenic patients and controls, indicating that the vol- ied with MRI. ume reduction was specific to these nuclei. Volume rela- tive to brain size was reduced in all 3 nuclei and remained Methods: A sample of 41 patients with schizophrenia significant when only patients who had never been ex- (32 men and 9 women) and 60 healthy volunteers (45 posed to neuroleptic medication (n=15) were consid- men and 15 women) underwent assessment with high- ered. For the MDN, women had larger relative volumes resolution 1.2-mm thick anatomical MRI. Images were than men among controls, but men had larger volumes differentiated to enhance the edges and outline of the than women among schizophrenic patients. whole thalamus, and the MDN, PUL, and CMN were out- lined on all slices by a tracer masked to diagnostic Conclusions: Three association regions of the thala- status.
    [Show full text]
  • Exploring Frontal Lobe Dysfunction in Schizophrenia with Positron Emission Tomography
    Jefferson Journal of Psychiatry Volume 8 Issue 1 Article 11 January 1990 Exploring Frontal Lobe Dysfunction in Schizophrenia with Positron Emission Tomography Donald P. Hall, Jr., M.D. National Institutes of Health, Bethesda, Maryland Follow this and additional works at: https://jdc.jefferson.edu/jeffjpsychiatry Part of the Psychiatry Commons Let us know how access to this document benefits ouy Recommended Citation Hall, Jr., M.D., Donald P. (1990) "Exploring Frontal Lobe Dysfunction in Schizophrenia with Positron Emission Tomography," Jefferson Journal of Psychiatry: Vol. 8 : Iss. 1 , Article 11. DOI: https://doi.org/10.29046/JJP.008.1.006 Available at: https://jdc.jefferson.edu/jeffjpsychiatry/vol8/iss1/11 This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Jefferson Journal of Psychiatry by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. Exploring Frontal Lobe Dysfunction in Schizophrenia with Positron Emission Tomography Donald P. Hall,jr., M.D. Frontal lobe dysfuncti on in schizo ph ren ic pa tients has been highly sus­ pected for many years. Man y psychiatrists and patients, however, are awaiting so lid p roofof a biological manifestation of this disease.
    [Show full text]
  • In Vivo Imaging of Neurotransmitter Systems Using Radio Labeled Receptor Ligands Lawrence S
    ELSEVIER In Vivo Imaging of Neurotransmitter Systems Using Radio labeled Receptor Ligands Lawrence S. Kegeles, M.D., Ph.D., and J. John Mann, M.D. In vivo functional brain imaging, including global blood overview of the methodology of development and selection of flow, regional cerebral blood flow (rCBF), measured with radioligands for PET and SPECT is presented. Studies positron emission tomography (PET) and single photon involving PET and SPECT ligand methods are reviewed emission computed tomography (SPECT), and regional and their findings summarized, including recent work cerebral metabolic rate (rCMR) measured with demonstrating successive mutual modulation of deoxyglucose PET, have been widely used in studies of neurotransmitter systems. Kinetic and equilibrium analysis psychiatric disorders. These studies have found modest modeling are reviewed. The emerging methodology of differences and required large numbers of patients. measuring neurotransmitter release on activation, both Activation studies using rCBF or rCMR as indices of pharmacologically and by task performance, using ligand neuronal activity are more sensitive because patients act as methods is reviewed and proposed as a promising new their own control; however, findings localize regions of approach for studying psychiatric disorders. change but provide no data about specific neurotransmitter [Neuropsychopharmacology 17:293-307, 1997] systems. After a general discussion of the role of © 1997 American College of Neuropsychopharmacology. neurotransmitter systems in neuropsychiatric
    [Show full text]
  • The Importance of Symptom Severity, Anxiety, and Melancholic Features
    ORIGINAL ARTICLES Brain Electrical Tomography in Depression: The Importance of Symptom Severity, Anxiety, and Melancholic Features Diego A. Pizzagalli, Jack B. Nitschke, Terrence R. Oakes, Andrew M. Hendrick, Kathryn A. Horras, Christine L. Larson, Heather C. Abercrombie, Stacey M. Schaefer, John V. Koger, Ruth M. Benca, Roberto D. Pascual-Marqui, and Richard J. Davidson Background: The frontal lobe has been crucially involved Key Words: Melancholic depression, anxiety, frontal in the neurobiology of major depression, but inconsisten- asymmetry, cingulate cortex, affect, source localization cies among studies exist, in part due to a failure of considering modulatory variables such as symptom sever- ity, comorbidity with anxiety, and distinct subtypes, as Introduction codeterminants for patterns of brain activation in depression. he region most frequently found to be dysfunctional in Methods: Resting electroencephalogram was recorded in Tmajor depressive disorder (MDD) is the prefrontal 38 unmedicated subjects with major depressive disorder cortex (PFC) (Brody et al 2001a; Davidson and Henriques, and 18 normal comparison subjects, and analyzed with a 2000). Distinct PFC subdivisions likely play different tomographic source localization method that computes the roles in the pathophysiology of depression: decreased cortical three-dimensional distribution of current density activation in the dorsolateral PFC (DLPFC) (Baxter et al for standard electroencephalogram frequency bands. 1989; Biver et al 1994; Bench et al 1992), but increases in Symptom severity and anxiety were measured via self- the ventrolateral PFC (VLPFC) (Biver et al 1994; Brody et report and melancholic features via clinical interview. al 1999, 2001b; Drevets et al 1992; Mayberg et al 1999) Results: Depressed subjects showed more excitatory (be- are among the most replicated findings.
    [Show full text]
  • Neuropsychological Consequences of Chronic Drug Use: Relevance to Treatment Approaches
    REVIEW published: 15 January 2016 doi: 10.3389/fpsyt.2015.00189 Neuropsychological Consequences of Chronic Drug Use: Relevance to Treatment Approaches Jean Lud Cadet1* and Veronica Bisagno2* 1 National Institute on Drug Abuse Intramural Program, Molecular Neuropsychiatry Research Branch, Baltimore, MD, USA, 2 Instituto de Investigaciones Farmacológicas (ININFA), Universidad de Buenos Aires-CONICET, Buenos Aires, Argentina Heavy use of drugs impacts of the daily activities of individuals in these activities. Several groups of investigators have indeed documented changes in cognitive performance by individuals who have a long history of chronic drug use. In the case of marijuana, a wealth of information suggests that heavy long-term use of the drug may have neurobehavioral consequences in some individuals. In humans, heavy cocaine use is accompanied by neuropathological changes that might serve as substrates for cognitive dysfunctions. Similarly, methamphetamine users suffer from cognitive abnormalities that may be con- sequent to alterations in structures and functions. Here, we detail the evidence for these neuropsychological consequences. The review suggests that improving the care of our Edited by: Vincent David, patients will necessarily depend on the better characterization of drug-induced cognitive Centre National de la Recherche phenotypes because they might inform the development of better pharmacological and Scientifique, France behavioral interventions, with the goal of improving cognitive functions in these subsets Reviewed by: of drug users. Aviv M. Weinstein, University of Ariel, Israel Keywords: marijuana, cocaine, methamphetamine, frontal cortex, cognition Hedy Kober, Yale University, USA *Correspondence: Jean Lud Cadet INTRODUCTION [email protected]; Veronica Bisagno Substance use disorders continue to be a major health concern worldwide.
    [Show full text]
  • Executive Control Processes: Dimensions, Development and ADHD
    Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences 27 Executive Control Processes: Dimensions, Development and ADHD KARIN C. BROCKI ACTA UNIVERSITATIS UPSALIENSIS ISSN 1652-9030 UPPSALA ISBN 978-91-554-6853-8 2007 urn:nbn:se:uu:diva-7788 ! "## #$%## & & & ' ( ) * ( + , -( "##( * - ' % .( ( "( $ ( ( /0+1 $23$43556372532( & ) 89!: & & 8*;: ) & & & . 8.:( & ) *; . ) & 8(( : ( < & . ) & = & 8/3/>: 3 & && ) ( & 0 /3/> 9! & *; ) . ( ?& & & 0 // /// /> ) 9! & && @ ( ! & 3 9! . ) & ) . & 3 ) & 9! ) . & 3 ( / & ) + @ 84$$: ) *; . ) & A B & & *; 9!( & & & .( ) & & ) & & . ( * & . ) ! " ! # $%%&! ! '()&$*% ! C , - + "## /001 475"3$## /0+1 $23$43556372532 % %%% 322 8 %DD ((D E F % %%% 322: “Completing a PhD thesis must be the ultimate test of one’s executive func- tions”. - Karin C. Brocki List of Papers I Brocki, K. C., & Bohlin, G. (2004). Executive Functions in Children age 6-13: A Dimensional and Developmental study. Developmental Neuropsychology,
    [Show full text]
  • Frontal Brain Activity in Individuals at Risk for Schizophrenic Psychosis and Bipolar Disorder During the Emotional Stroop Task - an Fnirs Study
    Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2020 Frontal brain activity in individuals at risk for schizophrenic psychosis and bipolar disorder during the emotional Stroop task - an fNIRS study Aleksandrowicz, Aleksandra ; Hagenmuller, Florence ; Haker, Helene ; Heekeren, Karsten ; Theodoridou, Anastasia ; Walitza, Susanne ; Ehlis, Ann-Christine ; Fallgatter, Andreas ; Rössler, Wulf ; Kawohl, Wolfram Abstract: OBJECTIVES: The emotional Stroop effect is defined as increased reaction times to emotional stimuli compared to neutral ones. It has been often reported in the literature, on both behavioral and neurophysiological level. The goal of this study was to investigate the frontal brain activation in individuals at risk for schizophrenic psychosis and bipolar disorder during an emotional Stroop task. We expected to observe decreased activation in the at-risk individuals compared to the healthy controls. METHODS: Individuals at high risk for psychosis (HR), at ultra-high risk for psychosis (UHR), at risk for bipolar disorder (BIP) and healthy controls (HC) performed an emotional Stroop task, which included positively, negatively and neutrally valenced words. Functional near-infrared spectroscopy (fNIRS) was used to measure levels of oxygenated hemoglobin (O2Hb) representing brain activity in the dorsolateral prefrontal and frontotemporal cortex. RESULTS: Results showed significantly decreased levels of O2Hb in the right dorsolateral prefrontal cortex (DLPFC) in the HR and UHR groups compared to the HC, indicating lower activity. Even though the decrease was independent from the valence of the words, it was the most visible for the negative ones. Moreover, significantly lower O2Hb levels in the frontotemporal cortex (FTC) were observed in all at risk groups compared to the HC.
    [Show full text]
  • Cannabis Abusers Show Hypofrontality and Blunted Brain Responses to a Stimulant Challenge in Females but Not in Males
    Neuropsychopharmacology (2016) 41, 2596–2605 © 2016 American College of Neuropsychopharmacology. All rights reserved 0893-133X/16 www.neuropsychopharmacology.org Cannabis Abusers Show Hypofrontality and Blunted Brain Responses to a Stimulant Challenge in Females but not in Males ,1 1 1 2 1 Corinde E Wiers* , Ehsan Shokri-Kojori , Christopher T Wong , Anissa Abi-Dargham , Şükrü B Demiral , 1 1 ,1,3 Dardo Tomasi , Gene-Jack Wang and Nora D Volkow* 1 2 National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA; Division of Translational Imaging, 3 Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA; National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA The extent to which cannabis is deleterious to the human brain is not well understood. Here, we test whether cannabis abusers (CA) have impaired frontal function and reactivity to dopaminergic signaling, which are fundamental to relapse in addiction. We measured brain 18 glucose metabolism using PET and [ F]FDG both at baseline (placebo) and after challenge with methylphenidate (MP), a dopamine- enhancing drug, in 24 active CA (50% female) and 24 controls (HC; 50% female). Results show that (i) CA had lower baseline glucose metabolism than HC in frontal cortex including anterior cingulate, which was associated with negative emotionality. (ii) MP increased whole-brain glucose metabolism in HC but not in CA; and group by challenge effects were most profound in putamen, caudate, midbrain, thalamus, and cerebellum. In CA, MP-induced metabolic increases in putamen correlated negatively with addiction severity. (iii) There were significant gender effects, such that both the group differences at baseline in frontal metabolism and the attenuated regional brain metabolic responses to MP were observed in female CA but not in male CA.
    [Show full text]
  • Hypofrontality and Negative Symptoms in Major Depressive Disorder
    NUCLEAR NEUROLOGY Hypofrontality and Negative Symptoms in Major Depressive Disorder Igor I. Galynker, Jun Cai, Fukiat Ongseng, Howard Finestone, Eamon Dutta and Dragos Serseni Departments of Psvchiatry and Radiology, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York MOD patients has been reported to be either reduced (5,7-9) or The purpose of the current study was to compare regional cerebral not different relative to control values (10,17). Lower values of blood flow (rCBF) in patients with major depressive disorder (MOD) rCBF in MOD patients than in control subjects have been to that of healthy subjects and to examine the relationship between observed in the left cerebral hemisphere (18), left dorsolateral rCBF, depressive symptoms (DS) and negative symptoms (NS) in prefrontal cortex (2,3,12,19), left prefrontal cortex (20), para- these patients. Methods: Eleven psychiatric inpatients with diag nosed (MOD) and 15 normal control subjects were administered the limbic regions (19,21), bilateral temporal regions (20) and scale for the assessment of negative symptoms (SANS) and the anterior parietal regions (9). The most consistent findings modified Hamilton rating scale for depression with items descriptive involved differences in the left prefrontal rCBF. Nevetheless, of NS excluded (HRSD-DS). Each patient underwent a SPECT scan several reports showed no abnormalities or higher values of using ""Tc-HMPAO at rest. Cortical and subcortical regions of rCBF or rCMRglc (10,17,22). interest (ROIs) were symmetrically defined in each hemisphere. The inconsistency in previous research findings could be Cortical-to-cerebellar perfusion ratios were established quantita related to several factors, including demographic consider tively using ADAC software.
    [Show full text]
  • 12.4 Schizophrenia: Neurobiology
    12.4 SCHIZOPHRENIA: NEUROBIOLOGY Kaplan & Sadock’s Comprehensive Textbook of Psychiatry CHAPTER 12. SCHIZOPHRENIA 12.4 SCHIZOPHRENIA: NEUROBIOLOGY MICHAEL F. EGAN, M.D., AND THOMAS M. HYDE, M.D., PH.D. Role of Genes and Environment Structural and Functional Neuroimaging Neuropathology Neurochemistry Neural Circuits Neurobiological Models Schizophrenia is a chronic mental illness affecting approximately 1 percent of the population. Beginning in early adulthood, schizophrenia typically causes a dramatic, lifelong impairment in social and occupational functioning. From a public health standpoint, the costs of treatment and lost productivity make this illness one of the most expensive disorders in medicine. Despite the tremendous economic and emotional costs, research on schizophrenia lags far behind that on other major medical disorders. A primary impediment to developing more effective treatment is the limited understanding of the etiology and neurobiology of this disorder. New technologies, such as neuroimaging and molecular genetics, are removing the obstacles that once blocked major progress in the field. Although the stigma associated with the illness has not yet been eliminated, these new techniques have markedly altered the conception of the nature of schizophrenia. One of the most rapidly changing fields is genetics. Family, twin, and adoption studies have clearly shown that genes play a prominent role in the development of schizophrenia. Estimates of heritability typically range from 50 to 85 percent. Initial attempts to isolate major genes using linkage studies were unsuccessful, but more recent approaches using increasingly sophisticated methods have uncovered several chromosomal regions that may harbor genes of minor effect. It seems likely that schizophrenia is the result of the interaction of many genes, some of which also interact with environmental factors.
    [Show full text]