Thalamic dysconnectivity in the psychosis risk syndrome and early illness schizophrenia

2021 ◽  
pp. 1-9
Author(s):  
Susanna L. Fryer ◽  
Jamie M. Ferri ◽  
Brian J. Roach ◽  
Rachel L. Loewy ◽  
Barbara K. Stuart ◽  
...  
Keyword(s):  
Chronically Ill ◽  
Anterior Cingulate ◽  
Positive Symptom ◽  
Imaging Data ◽  
Cross Sectional ◽  
Middle Temporal ◽  
Illness Onset ◽  
Psychosis Risk ◽  
Left And Right ◽  
Bilateral Thalamus

Abstract Background Schizophrenia (SZ) is associated with thalamic dysconnectivity. Compared to healthy controls (HCs), individuals with SZ have hyperconnectivity with sensory regions, and hypoconnectivity with cerebellar, thalamic, and prefrontal regions. Despite replication of this pattern in chronically ill individuals, less is known about when these abnormalities emerge in the illness course and if they are present prior to illness onset. Methods Resting-state functional magnetic resonance imaging data were collected from psychosis risk syndrome (PRS) youth (n = 45), early illness SZ (ESZ) (n = 74) patients, and HCs (n = 85). Age-adjusted functional connectivity, seeded from the thalamus, was compared among the groups. Results Significant effects of group were observed in left and right middle temporal regions, left and right superior temporal regions, left cerebellum, and bilateral thalamus. Compared to HCs, ESZ demonstrated hyperconnectivity to all temporal lobe regions and reduced connectivity with cerebellar, anterior cingulate, and thalamic regions. Compared to HCs, PRS demonstrated hyperconnectivity with the left and right middle temporal regions, and hypoconnectivity with the cerebellar and other thalamic regions. Compared to PRS participants, ESZ participants were hyperconnected to temporal regions, but did not differ from PRS in hypoconnectivity with cerebellar and thalamic regions. Thalamic dysconnectivity was unrelated to positive symptom severity in ESZ or PRS groups. Conclusions PRS individuals demonstrated an intermediate level of thalamic dysconnectivity, whereas ESZ showed a pattern consistent with prior observations in chronic samples. These cross-sectional findings suggest that thalamic dysconnectivity may occur prior to illness onset and become more pronounced in early illness stages.

scholarly journals Global and Specific Cortical Volume Asymmetries in Individuals With Psychosis Risk Syndrome and Schizophrenia: A Mixed Cross-sectional and Longitudinal Perspective

2019 ◽  
Vol 46 (3) ◽  
pp. 713-721
Author(s):  
Katherine S F Damme ◽  
Teresa Vargas ◽  
Vince Calhoun ◽  
Jessica Turner ◽  
Vijay A Mittal
Keyword(s):  
Repeated Measure ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Illness Onset ◽  
Clinical Interviews ◽  
Pathogenic Factors ◽  
Psychosis Risk ◽  
Measure Design ◽  
Healthy Control ◽  
Neurodevelopmental Hypothesis

Abstract Cortical volumetric asymmetry (CVA) has been widely observed in individuals with psychosis, and is associated with etiological risk factors (e.g., genetics, neuromaturation) and treatment response. However, it is unclear whether CVA abnormalities emerge before psychotic illness onset. Understanding whether CVA manifests in clinical high-risk (CHR)—compared with healthy controls and schizophrenia patients (SCZ)—over time may inform our understanding of pathogenic factors. A total of 233 individuals: 73 CHR, 112 healthy controls, and 48 SCZ underwent an MRI and clinical interviews. Ninety-four individuals including healthy volunteers (HV) (n = 49) and CHR (n = 45), completed another scan at 12-months. CVA was compared by lobe in a repeated-measure design across groups, then nested by time in a longitudinal model. CHR and SCZ groups showed reduced global CVA compared with the healthy control groups but the CHR and SCZ group did not differ from each other. A group by lobe interaction indicated the presence of lobe specific reductions in frontal and cingulate CVA. Cingulate CVA was reduced in CHR and SCZ groups compared to HC groups but did not differ from each other. Frontal CVA was reduced in the older healthy controls compared with younger-HC and CHR, but did not differ from the similarly aged SZ group. CVA is similarly impacted in SCZ and CHR groups, potentially reflecting pathogenic processes. Longitudinal analyses provided further support for the neurodevelopmental hypothesis as CHR exhibited longitudinal changes in opposite directions from normative neuromaturation in HV, which was related to increasing risk for psychosis in the CHR.

scholarly journals Interactive impact of childhood maltreatment, depression, and age on cortical brain structure: mega-analytic findings from a large multi-site cohort

2019 ◽  
Vol 50 (6) ◽  
pp. 1020-1031 ◽  
Author(s):  
Leonardo Tozzi ◽  
Lisa Garczarek ◽  
Deborah Janowitz ◽  
Dan J. Stein ◽  
Katharina Wittfeld ◽  
...  
Keyword(s):  
Surface Area ◽  
Temporal Lobe ◽  
Cortical Thickness ◽  
Childhood Maltreatment ◽  
Parietal Lobe ◽  
Anterior Cingulate ◽  
Brain Maturation ◽  
Imaging Data ◽  
Childhood Trauma Questionnaire ◽  
Middle Temporal

AbstractBackgroundChildhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.MethodsWithin the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.ResultsCM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.ConclusionsSeverity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.

Dynamics of the right atrio-ventricular junction in human: a spatial high-resolution study with multiphase computed tomography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Jouan ◽  
I Masari ◽  
V Bliah ◽  
G Soulat ◽  
D Craiem ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Cycle ◽  
Cardiac Computed Tomography ◽  
Reconstruction Method ◽  
Imaging Data ◽  
High Definition ◽  
Vertical Projection ◽  
Horizontal Projection ◽  
Cross Sectional ◽  
The Right

Abstract Introduction In order to improve knowledge of the tricuspid valve (TV) function and its coupling with the right atrio-ventricular junction (RAVJ) and right ventricle (RV), new four-dimensional high-definition imagery methods are mandatory (3D+t). Purpose Using an innovative reconstruction method based on multiphase cardiac computed tomography imaging (4D-MCCTI), we finely analyzed the morphological & dynamical features of tricuspid annulus (TA) and RAVJ components in order to assess new functional parameters of TV and RV functions. Methods Volume imaging data sets through time were obtained from 4D-MCCTI of 30 subjects (sex ratio 1, mean age 57±11y.) with no rhythm, valvular or ventricular abnormalities on echocardiography and implemented in a custom software for 3D semi-automated delineation of 18 points around TA perimeter. Coordinates of these points in each of the 10 time-phases within an RR interval were used to calculate specific geometrical features of TA such as 3D/2D areas, perimeters, 360°-diameters and vertical deformation. Subsequently, RV and Right Atrium (RA) inner contours were also delineated (Figure). Results TA shape was elliptical in horizontal projection with a mean eccentricity index (EcI) of 0.58±0.12; and saddle-shapped in vertical projection with a horn nearby the antero-septal commissure. This feature remained throughout the cardiac cycle but TA was more planar (minimal TA-height: 4.47±1.04 mm) and circular (minimal EcI=0.44±0.14) in mid-diastole when TA-3Darea and TA-3Dperimeter reached a maximum of 6.98±1.21 cm2/m2 and 7.41±0.91 cm, respectively. Correlation between TA-3Darea, TA-2Darea and latero-septal diameter (LSD) were R2=0.99 and R2=0.73, respectively. LSD was minimal in early-systole (18.83±3.04 mm/m2) and maximal in mid-diastole (20.04±3.05 mm/m2). Correlation of TA-3Darea with RV and RA cross-sectional areas were R2=0.82 and R2=0.71, respectively. Conversely, there was no significant correlation between TA, RV and RA concentric contractions. Conclusions Our method for 4D-MTCCI analysis has allowed confirming the shape and dynamics function of RAVJ throughout the cardiac cycle in healthy subjects, and giving new reference parameters for TV and RV evaluation. Software multiplanar view of TA Funding Acknowledgement Type of funding source: None

scholarly journals Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

2021 ◽  
pp. 1-10
Author(s):  
Stephanie Paula Elisabeth Guillery ◽  
Rainer Hellweg ◽  
Golo Kronenberg ◽  
Ulrich Bohr ◽  
Hagen Kunte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Replacement Therapy ◽  
Psychological Functioning ◽  
Treatment Options ◽  
Chronically Ill ◽  
Cross Sectional ◽  
Life Improvement ◽  
Methadone Patients ◽  
Opioid Replacement Therapy

<b><i>Background:</i></b> Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. <b><i>Objectives:</i></b> Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (<i>n</i> = 126), diamorphine (<i>n</i> = 85), or buprenorphine (<i>n</i> = 37) were recruited in 6 German therapy centers. <b><i>Methods:</i></b> Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the <i>Profile of the Quality of Life in the Chronically Ill</i> (PLC) questionnaire. <b><i>Results:</i></b> Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (<i>p</i> &#x3c; 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (<i>p</i> &#x3c; 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.141). Diamorphine patients reported a higher psychological functioning (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.078) and overall life improvement (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.060) compared to methadone, but not compared to buprenorphine patients (both <i>p</i> &#x3e; 0.25). <b><i>Conclusion:</i></b> Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

scholarly journals Mandibular range of motion in children with juvenile idiopathic arthritis with and without clinically established temporomandibular joint involvement and in healthy children; a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Willemijn F. C. de Sonnaville ◽  
Caroline M. Speksnijder ◽  
Nicolaas P. A. Zuithoff ◽  
Daan R. C. Verkouteren ◽  
Nico W. Wulffraat ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Range Of Motion ◽  
Temporomandibular Joint ◽  
Cross Sectional Study ◽  
Joint Involvement ◽  
Healthy Children ◽  
Sectional Study ◽  
Cross Sectional ◽  
Explanatory Factors ◽  
Left And Right

Abstract Background Recognition of temporomandibular joint (TMJ) involvement in children with juvenile idiopathic arthritis (JIA) has gained increasing attention in the past decade. The clinical assessment of mandibular range of motion characteristics is part of the recommended variables to detect TMJ involvement in children with JIA. The aim of this study was to explore explanatory variables for mandibular range of motion outcomes in children with JIA, with and without clinically established TMJ involvement, and in healthy children. Methods This cross-sectional study included children with JIA and healthy children of age 6–18 years. Mandibular range of motion variables included active and passive maximum interincisal opening (AMIO and PMIO), protrusion, laterotrusion, dental midline shift in AMIO and in protrusion. Additionally, the TMJ screening protocol and palpation pain were assessed. Adjusted linear regression analyses of AMIO, PMIO, protrusion, and laterotrusion were performed to evaluate the explanatory factors. Two adjusted models were constructed: model 1 to compare children with JIA and healthy children, and model 2 to compare children with JIA with and without TMJ involvement. Results A total of 298 children with JIA and 169 healthy children were included. Length was an explanatory variable for the mandibular range of motion excursions. Each centimeter increase in length increased AMIO (0.14 mm), PMIO (0.14 mm), and protrusion (0.02 mm). Male gender increased AMIO by 1.35 mm. Having JIA negatively influenced AMIO (3.57 mm), PMIO (3.71 mm), and protrusion (1.03 mm) compared with healthy children, while the discrepancy between left and right laterotrusion raised 0.68 mm. Children with JIA and TMJ involvement had a 8.27 mm lower AMIO, 7.68 mm lower PMIO and 0.96 mm higher discrepancy in left and right laterotrusion compared to healthy children. Conclusion All mandibular range of motion items were restricted in children with JIA compared with healthy children. In children with JIA and TMJ involvement, AMIO, PMIO and the discrepancy between left and right laterotrusion were impaired more severely. The limitation in protrusion and laterotrusion was hardly clinically relevant. Overall, AMIO is the mandibular range of motion variable with the highest restriction (in millimeters) in children with JIA and clinically established TMJ involvement compared to healthy children.

scholarly journals M146. NEUROCHEMICAL MODULATION OF AUDITORY CORTEX FUNCTIONAL CONNECTIVITY IN PATIENTS WITH AUDITORY VERBAL HALLUCINATIONS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S191-S191
Author(s):  
Sarah Weber ◽  
Helene Hjelmervik ◽  
Alexander R Craven ◽  
Erik Johnsen ◽  
Rune Kroken ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Temporal Lobe ◽  
Superior Temporal Gyrus ◽  
Underlying Mechanism ◽  
Auditory Hallucinations ◽  
Anterior Cingulate ◽  
Gamma Aminobutyric Acid ◽  
Auditory Verbal Hallucinations ◽  
Left And Right ◽  
Neurochemical Correlates

Abstract Background Auditory hallucinations have been linked to aberrant functioning of the left superior temporal gyrus (STG) and are associated with impaired cognitive control regulated by areas in the prefrontal cortex. However, the mechanisms behind these dysfunctions are still unclear. Methods The current study combined resting state connectivity fMRI with MR spectroscopy (MRS) in a sample of 81 psychosis patients to explore how neurochemical correlates of auditory hallucinations modulate left STG functioning. The analyses were focused on glutamate (Glu) and gamma-aminobutyric acid (GABA), two neurotransmitters with excitatory and inhibitory functions, respectively, since these have previously been implicated in psychosis. Results Glu and GABA showed differential relationships with left STG connectivity in patients with and without hallucinations. Specifically, Glu concentration in the anterior cingulate cortex (ACC) was positively related to functional connectivity between the left and right temporal lobe in hallucinating patients only. In contrast, GABA concentration in the ACC was negatively related to connectivity between the left and right temporal lobe in non-hallucinating patients only. Discussion These findings support a recently proposed model of interhemispheric temporal lobe miscommunication in auditory hallucinations and indicate prefrontal neurochemical modulation as a potential underlying mechanism. The results can further be integrated with previously suggested excitatory/inhibitory imbalances as neurochemical modulators in AVH.

Clinical and epidemiological features of community-acquired pneumonia during an epidemic of respiratory viral infection

2021 ◽  
Vol 31 (4) ◽  
pp. 490-498
Author(s):  
N. I. Izmozherova ◽  
A. A. Popov ◽  
E. R. Prokopeva ◽  
A. A. Kuryndina ◽  
E. I. Gavrilova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Streptococcus Pneumoniae ◽  
Causative Agent ◽  
Community Acquired Pneumonia ◽  
Influenza Viruses ◽  
X Rays ◽  
Imaging Data ◽  
Cross Sectional ◽  
Epidemiological Features ◽  
Working Age

Community-acquired pneumonia (CAP) is one of the most common lower respiratory tract diseases. An increase in the CAP incidence has been reported to be associated with epidemics of acute respiratory viral infections (ARVI).Aim. Аssess clinical and epidemiological features of CAP in patients admitted to hospital during an ARVI epidemic.Methods. A cross-sectional study included 208 patient records. Medical history, physical examination, laboratory and imaging data were analyzed. CAP severity was assessed by CRB-65 scale and the systemic inflammatory response syndrome (SIRS) criteria.Results. Most CAP patients (75%) were of active working age; all presented signs of ARVI upon admission. Nasal mucosa diagnostic smears have revealed type A influenza viruses: H1N1 – 5 (83.3%) and H3N2 – 1 (16.7%) cases. 195 (93.8%) patients were not vaccinated against influenza. X-rays showed that unilateral (81.7%) and lobular pneumonia (55.8%) were the most common CAP types. 93.2% patients had nonsevere CAP, according to CRB-65. But 88 (42.3%) subjects qualified for SIRS upon admission. Concomitant conditions as risk factors of an adverse course of CAP were present in 89 patients (42.8%). Sputum analysis, if available, most frequently identified Streptococcus pneumoniae (23 cases or 38.9%) as a causative agent. Antibacterial drugs (ABD) used to treat CAP were ceftriaxone 206 (99%), macrolides 188 (90.4%), and fluoroquinolones 94 (45.2%). The initial antibacterial treatment regimens were: 186 (89.4%) prescriptions of ceftriaxone + macrolides, 16 (7.7%) prescriptions of ceftriaxone alone, and 6 (2.9%) prescriptions of levofloxacin. A switch between ABDs was reported in 78 (37.5%) cases, including 61 switches to fluoroquinolones. The median ABD administration duration was 10 (8 – 13) days.Conclusion. Most of the hospitalized CAP patients were of working age and not vaccinated against influenza. Streptococcus pneumoniae was the most common causative agent. PCR (polymerase chain reaction) smear analysis was performed only in 6 patients with ARVI, which does not allow us to assess the role of viruses and viral-bacterial associations in the etiology of CAP. In spite of non-severe CAP, all hospitalizations were justified, due to multiple risk factors of unfavorable prognosis of CAP and epidemiological factors. Most patients received a combination of generation 3 cephalosporins and macrolides as the initial therapy for CAP.

scholarly journals Framing and Self-Responsibility Modulate Brain Activities in Decision Escalation

2021 ◽  
Author(s):  
Ting-Peng Liang ◽  
Yuwen Li ◽  
Nai-Shing Yen ◽  
Ofir Turel ◽  
Sen-Mou Hsu
Keyword(s):  
Anterior Cingulate Cortex ◽  
Contextual Factors ◽  
Inferior Frontal Gyrus ◽  
Cingulate Cortex ◽  
Brain Regions ◽  
Anterior Cingulate ◽  
Imaging Data ◽  
Two Factors ◽  
Human Decision

Abstract Background: Escalation of commitment is a common bias in human decision making. The present study examined (1) differences in neural recruitment for escalation and de-escalation decisions of prior investments, and (2) how the activations of these brain networks are modulated by two factors that are often argued to modulate the behavior: (i) self-responsibility, and (ii) framing of the success probabilities. Results: Imaging data were obtained from functional magnetic resonance imaging (fMRI) applied to 29 participants. A whole-brain analysis was conducted to compare brain activations between conditions. ROI analysis, then, was used to examine if these significant activations were modulated by two contextual factors. Finally, mediation analysis was applied to explore how the contextual factors affect escalation decisions through brain activations. The findings showed that (1) escalation decisions are faster than de-escalation decisions, (2) the corresponding network of brain regions recruited for escalation (anterior cingulate cortex, insula and precuneus) decisions differs from this recruited for de-escalation decisions (inferior and superior frontal gyri), (3) the switch from escalation to de-escalation is primarily frontal gyri dependent, and (4) activation in the anterior cingulate cortex, insula and precuneus were further increased in escalation decisions, when the outcome probabilities of the follow-up investment were positively framed; and activation in the inferior and superior frontal gyri in de-escalation decisions were increased when the outcome probabilities were negatively framed. Conclusions: Escalation and de-escalation decisions recruit different brain regions. Framing of possible outcomes as negative leads to escalation decisions through recruitment of the inferior frontal gyrus. Responsibility for decisions affects escalation decisions through recruitment of the superior (inferior) gyrus, when the decision is framed positively (negatively).

Is There a Measurable Difference between the Left and Right Modified Myocardial Performance Indices, and Does This Change to Reflect Unilateral Myocardial Dysfunction in Pathology?

2015 ◽  
Vol 38 (4) ◽  
pp. 288-295 ◽  
Author(s):  
Alec W. Welsh ◽  
Amanda Henry ◽  
Neama Meriki ◽  
Aditi Mahajan ◽  
Linda Wu ◽  
...  
Keyword(s):  
Myocardial Dysfunction ◽  
Cross Sectional Study ◽  
Myocardial Performance ◽  
Performance Indices ◽  
Cross Sectional ◽  
Pilot Data ◽  
Design Function ◽  
Left And Right ◽  
First Time ◽  
Twin Pregnancies

Introduction: Fetal cardiac dysfunction may manifest itself unilaterally as right and left ventricles differing in design, function and load, measurable as differing in myocardial performance indices (MPIs). We wished to define this difference (‘delta-MPI' or DMPI), present its normal range and pilot its use in pathological pregnancy. Material and Methods: Prospective cross-sectional study of 324 normal singleton fetuses (16-38 weeks of gestation). Left and right modified MPI (LMPI and RMPI) were performed during a single examination using the ‘peak' valve click technique. Thirty-seven pathological singleton and monochorionic diamniotic twin pregnancies were compared as pilot data. Results: Modified MPIs (mean ± SD) were 0.45 ± 0.06 (LMPI) and 0.47 ± 0.09 (RMPI), being similar at 18 weeks' gestation with DMPI increasing slightly throughout pregnancy (0.02 ± 0.08). Both singleton intrauterine growth restriction (IUGR) and recipient twin-twin transfusion syndrome (TTTS) showed significantly elevated RMPI, LMPI and DMPI, most pronounced for DMPI (450 and 500% increase, respectively; p < 0.01). DMPI acquisition rates were 83.3% normal and 87.0% pathological. Discussion: We demonstrate for the first time differing intrafetal LMPI and RMPI in a large gestational cohort, with this difference increasing with gestational age. Pilot data confirm the potential for DMPI as a tool to assess unilateral myocardial function in singleton IUGR and recipient twins in TTTS, and further studies are under way to evaluate its clinical utility.

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