Reduced cortical thickness of the paracentral lobule in at-risk mental state individuals with poor 1-year functional outcomes

AbstractAlthough widespread cortical thinning centered on the fronto-temporal regions in schizophrenia has been reported, the findings in at-risk mental state (ARMS) patients have been inconsistent. In addition, it remains unclear whether abnormalities of cortical thickness (CT) in ARMS individuals, if present, are related to their functional decline irrespective of future psychosis onset. In this multicenter study in Japan, T1-weighted magnetic resonance imaging was performed at baseline in 107 individuals with ARMS, who were subdivided into resilient (77, good functional outcome) and non-resilient (13, poor functional outcome) groups based on the change in Global Assessment of Functioning scores during 1-year follow-up, and 104 age- and sex-matched healthy controls recruited at four scanning sites. We measured the CT of the entire cortex and performed group comparisons using FreeSurfer software. The relationship between the CT and cognitive functioning was examined in an ARMS subsample (n = 70). ARMS individuals as a whole relative to healthy controls exhibited a significantly reduced CT, predominantly in the fronto-temporal regions, which was partly associated with cognitive impairments, and an increased CT in the left parietal and right occipital regions. Compared with resilient ARMS individuals, non-resilient ARMS individuals exhibited a significantly reduced CT of the right paracentral lobule. These findings suggest that ARMS individuals partly share CT abnormalities with patients with overt schizophrenia, potentially representing general vulnerability to psychopathology, and also support the role of cortical thinning in the paracentral lobule as a predictive biomarker for short-term functional decline in the ARMS population.

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Neuroanatomical correlates of different vulnerability states for psychosis and their clinical outcomes

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.052068 ◽

2009 ◽

Vol 195 (3) ◽

pp. 218-226 ◽

Cited By ~ 60

Author(s):

Nikolaos Koutsouleris ◽

Gisela J. E. Schmitt ◽

Christian Gaser ◽

Ronald Bottlender ◽

Johanna Scheuerecker ◽

...

Keyword(s):

At Risk ◽

Clinical Outcome ◽

Mental State ◽

Grey Matter ◽

Mental States ◽

Grey Matter Volume ◽

Healthy Controls ◽

Imaging Data ◽

Matter Volume ◽

At Risk Mental State

BackgroundStructural brain abnormalities have been described in individuals with an at-risk mental state for psychosis. However, the neuroanatomical underpinnings of the early and late at-risk mental state relative to clinical outcome remain unclear.AimsTo investigate grey matter volume abnormalities in participants in a putatively early or late at-risk mental state relative to their prospective clinical outcome.MethodVoxel-based morphometry of magnetic resonance imaging data from 20 people with a putatively early at-risk mental state (ARMS–E group) and 26 people with a late at-risk mental state (ARMS–L group) as well as from 15 participants with at-risk mental states with subsequent disease transition (ARMS–T group) and 18 participants without subsequent disease transition (ARMS–NT group) were compared with 75 healthy volunteers.ResultsCompared with healthy controls, ARMS–L participants had grey matter volume losses in frontotemporolimbic structures. Participants in the ARMS–E group showed bilateral temporolimbic alterations and subtle prefrontal abnormalities. Participants in the ARMS–T group had prefrontal alterations relative to those in the ARMS–NT group and in the healthy controls that overlapped with the findings in the ARMS–L group.ConclusionsBrain alterations associated with the early at-risk mental state may relate to an elevated susceptibility to psychosis, whereas alterations underlying the late at-risk mental state may indicate a subsequent transition to psychosis.

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Poster #40 LONGITUDINAL HEMODYNAMIC CHANGES AND PREDICTION OF FUNCTIONAL OUTCOME IN AT-RISK MENTAL STATE AND FIRST-EPISODE PSYCHOSIS

Schizophrenia Research ◽

10.1016/s0920-9964(12)70612-6 ◽

2012 ◽

Vol 136 ◽

pp. S199-S200

Author(s):

Shinsuke Koike ◽

Yoshihiro Satomura ◽

Yukika Nishimura ◽

Yosuke Takano ◽

Norichika Iwashiro ◽

...

Keyword(s):

At Risk ◽

Functional Outcome ◽

Mental State ◽

First Episode Psychosis ◽

First Episode ◽

Hemodynamic Changes ◽

Episode Psychosis ◽

At Risk Mental State

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Poster #S64 NEUROANATOMICAL PREDICTORS OF FUNCTIONAL OUTCOME IN THE AT-RISK MENTAL STATE

Schizophrenia Research ◽

10.1016/s0920-9964(14)70343-3 ◽

2014 ◽

Vol 153 ◽

pp. S111-S112

Author(s):

Renate L. Reniers ◽

Ashleigh Lin ◽

Alison Yung ◽

Nikolaos Koutsouleris ◽

Barnaby Nelson ◽

...

Keyword(s):

At Risk ◽

Functional Outcome ◽

Mental State ◽

At Risk Mental State

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Transition to Psychosis: 6-Month follow-up of a Chinese High-Risk Group in Hong Kong

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2006.01817.x ◽

2006 ◽

Vol 40 (5) ◽

pp. 414-420 ◽

Cited By ~ 25

Author(s):

May M.L. Lam ◽

Se-Fong Hung ◽

Eric Y.H. Chen

Keyword(s):

At Risk ◽

High Risk ◽

Mental State ◽

Functional Decline ◽

High Risk Group ◽

Psychotic Symptoms ◽

Syndrome Scale ◽

History Of ◽

At Risk Mental State

Objectives: The identification of individuals at high risk of becoming psychotic within the near future creates opportunities for early intervention before the onset of psychosis. This study sets out to identify a group of symptomatic young people in a Chinese population with the high likelihood of transition to psychosis within a follow-up period of 6 months, and to determine the rate of transition to psychosis in this group. Method: Symptomatic individuals with a family history of psychotic disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were identified using the operationalized criteria of an ‘At Risk Mental State’. The individuals were prospectively assessed monthly on a measure of psychopathology for 6 months. Results: Eighteen out of 62 individuals (29%) made the transition to frank psychosis within a 6 month follow-up period, with the majority occurring within 3 months. In addition, significant differences were found in the intake Positive and Negative Syndrome Scale, Comprehensive Assessment of ‘At Risk Mental State’ and Global Assessment of Functioning scores between the group that ultimately became psychotic and the group that did not. Conclusion: The period of the highest risk of transition to psychosis was within the 3 months after the study began. Thus, distressed youths in our outpatient clinic, who meet the high-risk criteria should be monitored most closely in the initial 3 months, particularly those individuals with high levels of psychopathology and functional decline.

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VERBAL EPISODIC MEMORY IN FIRST EPISODE AND AT RISK MENTAL STATE FOR PSYCHOSIS PATIENTS COMPARED TO DEPRESSIVE PATIENTS AND HEALTHY CONTROLS

Schizophrenia Research ◽

10.1016/j.schres.2010.02.834 ◽

2010 ◽

Vol 117 (2-3) ◽

pp. 449

Author(s):

Ronan Zimmermann ◽

Ute Gschwandtner ◽

Marlon O. Pflueger ◽

Carla Schulze ◽

Anita Riecher-Rössler

Keyword(s):

At Risk ◽

Episodic Memory ◽

Mental State ◽

First Episode ◽

Healthy Controls ◽

Depressive Patients ◽

Verbal Episodic Memory ◽

At Risk Mental State

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Elucidating neuroanatomical alterations in the at risk mental state and first episode psychosis: A combined voxel-based morphometry and voxel-based cortical thickness study

Schizophrenia Research ◽

10.1016/j.schres.2013.08.030 ◽

2013 ◽

Vol 150 (2-3) ◽

pp. 505-511 ◽

Cited By ~ 19

Author(s):

Stefania Benetti ◽

William Pettersson-Yeo ◽

Chloe Hutton ◽

Marco Catani ◽

Steve CR Williams ◽

...

Keyword(s):

At Risk ◽

Cortical Thickness ◽

Mental State ◽

First Episode Psychosis ◽

First Episode ◽

Voxel Based Morphometry ◽

Episode Psychosis ◽

At Risk Mental State

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EEG-Based Measures in At-Risk Mental State and Early Stages of Schizophrenia: A Systematic Review

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.653642 ◽

2021 ◽

Vol 12 ◽

Author(s):

Andrea Perrottelli ◽

Giulia Maria Giordano ◽

Francesco Brando ◽

Luigi Giuliani ◽

Armida Mucci

Keyword(s):

Systematic Review ◽

At Risk ◽

High Risk ◽

Functional Outcome ◽

Mental State ◽

P300 Amplitude ◽

Early Stages ◽

Eeg Abnormalities ◽

Related Potentials ◽

At Risk Mental State

Introduction: Electrophysiological (EEG) abnormalities in subjects with schizophrenia have been largely reported. In the last decades, research has shifted to the identification of electrophysiological alterations in the prodromal and early phases of the disorder, focusing on the prediction of clinical and functional outcome. The identification of neuronal aberrations in subjects with a first episode of psychosis (FEP) and in those at ultra high-risk (UHR) or clinical high-risk (CHR) to develop a psychosis is crucial to implement adequate interventions, reduce the rate of transition to psychosis, as well as the risk of irreversible functioning impairment. The aim of the review is to provide an up-to-date synthesis of the electrophysiological findings in the at-risk mental state and early stages of schizophrenia.Methods: A systematic review of English articles using Pubmed, Scopus, and PsychINFO was undertaken in July 2020. Additional studies were identified by hand-search. Electrophysiological studies that included at least one group of FEP or subjects at risk to develop psychosis, compared to healthy controls (HCs), were considered. The heterogeneity of the studies prevented a quantitative synthesis.Results: Out of 319 records screened, 133 studies were included in a final qualitative synthesis. Included studies were mainly carried out using frequency analysis, microstates and event-related potentials. The most common findings included an increase in delta and gamma power, an impairment in sensory gating assessed through P50 and N100 and a reduction of Mismatch Negativity and P300 amplitude in at-risk mental state and early stages of schizophrenia. Progressive changes in some of these electrophysiological measures were associated with transition to psychosis and disease course. Heterogeneous data have been reported for indices evaluating synchrony, connectivity, and evoked-responses in different frequency bands.Conclusions: Multiple EEG-indices were altered during at-risk mental state and early stages of schizophrenia, supporting the hypothesis that cerebral network dysfunctions appear already before the onset of the disorder. Some of these alterations demonstrated association with transition to psychosis or poor functional outcome. However, heterogeneity in subjects' inclusion criteria, clinical measures and electrophysiological methods prevents drawing solid conclusions. Large prospective studies are needed to consolidate findings concerning electrophysiological markers of clinical and functional outcome.

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T22. RELATIONSHIP BETWEEN CORTICAL THICKNESS AND FUNCTIONAL OUTCOME IN INDIVIDUALS AT RISK OF PSYCHOSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.582 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S239-S240

Author(s):

Daiki Sasabayashi ◽

Yoichiro Takayanagi ◽

Tsutomu Takahashi ◽

Yuko Mizukami ◽

Naoyuki Katagiri ◽

...

Keyword(s):

At Risk ◽

Functional Outcome ◽

Cortical Thickness ◽

Predictive Marker ◽

Mri Studies ◽

Healthy Control ◽

Magnetic Resonance Imaging Mri ◽

And Gender ◽

The Right

Abstract Background Previous magnetic resonance imaging (MRI) studies in patients with schizophrenia have demonstrated reduced cortical thickness predominantly in the fronto-temporal regions, but several MRI studies of regional cortical thickness in individuals at clinical high-risk for psychosis have reported inconsistent results. In addition, it remains elusive whether abnormalities of the cortical thickness in individuals at risk of psychosis, if present, are related to their functional outcome. Methods T1-weighted structural MR scans were obtained from 107 individuals with at-risk mental state (ARMS), of whom 21 (19.6%) later developed psychosis during clinical follow-up (mean = 4.9 years, SD = 2.6 years), as well as 104 age- and gender- matched healthy control subjects recruited at 4 scanning sites (University of Toyama, Toho University, Tohoku University, and The University of Tokyo). ARMS individuals were subdivided into good (ARMS-G, n = 77) and poor (ARMS-P, n = 13) outcome groups based on the Global Assessment of Functioning (GAF) scores both at baseline and 1-year follow-up. After preprocessing MR images using FreeSurfer software (ver.5.3.), we continuously measured the cortical thickness of entire cortex. A general linear model controlling for age, gender, and sites was used to estimate group differences. To correct for multiple comparisons, a Monte Carlo simulation procedure was used. This study was approved by the Committees on Medical Ethics of each site. After a complete description of the study was provided, written informed consent was obtained from all subjects. Results Compared with the controls, ARMS individuals exhibited significantly reduced cortical thickness in the superior and inferior frontal gyri, parahippocampal gyri, fusiform gyri, temporal pole cortices, and insula cortices bilaterally, as well as in the left middle frontal gyrus and right precuneus cortex. ARMS individuals also showed significantly increased cortical thickness in the left pre- and postcentral gyrus and right pericalcarine cortex in comparison to the controls. Within ARMS population, ARMS-P individuals had significantly reduced cortical thickness in the right paracentral lobule compared with ARMS-G individuals. Discussion Cortical thinning in the fronto-temporal regions as well as cortical thickening in the posterior cortices seen in ARMS individuals might be associated with general vulnerability to psychopathology. Furthermore, cortical thickness of the right paracentral lobule could be a predictive marker for functional outcome in ARMS population.

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