Investigating the Relationship between White Matter Connectivity and Motivational Circuits in Subjects with Deficit Schizophrenia: A Diffusion Tensor Imaging (DTI) Study

Deficit schizophrenia is a subtype of schizophrenia presenting primary and enduring negative symptoms (NS). Although one of the most updated hypotheses indicates a relationship between NS and impaired motivation, only a few studies have investigated abnormalities of motivational circuits in subjects with deficit schizophrenia (DS). Our aim was to investigate structural connectivity within motivational circuits in DS. We analyzed diffusion tensor imaging (DTI) data from 46 subjects with schizophrenia (SCZ) and 35 healthy controls (HCs). SCZ were classified as DS (n = 9) and non-deficit (NDS) (n = 37) using the Schedule for Deficit Syndrome. The connectivity index (CI) and the Fractional Anisotropy (FA) of the connections between selected brain areas involved in motivational circuits were examined. DS, as compared with NDS and HCs, showed increased CI between the right amygdala and dorsal anterior insular cortex and increased FA of the pathway connecting the left nucleus accumbens with the posterior insular cortex. Our results support previous evidence of distinct neurobiological alterations underlying different clinical subtypes of schizophrenia. DS, as compared with NDS and HCs, may present an altered pruning process (consistent with the hyperconnectivity) in cerebral regions involved in updating the stimulus value to guide goal-directed behavior.

Corpus callosum in schizophrenia with deficit and non-deficit syndrome: a statistical shape analysis

BackgroundThe corpus callosum (CC) is the most targeted region in the cerebrum that integrates cognitive data between homologous areas in the right and left hemispheres.AimsOur study used statistical analysis to determine whether there was a correlation between shape changes in the CC in patients with schizophrenia (SZ) (deficit syndrome (DS) and non-deficit syndrome (NDS)) and healthy control (HC) subjects.MethodsThis study consisted of 27 HC subjects and 50 schizophrenic patients (20 with DS and 30 with NDS). 3 patients with DS and 4 patients with NDS were excluded. Three-dimensional, sagittal, T1-spoiled, gradient-echo imaging was used. Standard anatomical landmarks were selected and marked on each image using specific software.ResultsAs to comparing the Procrustes mean shapes of the CC, statistically significant differences were observed between HC and SZ (DS+NDS) (p=0.017, James’s Fj=73.732), HC and DS (p<0.001, James’s Fj=140.843), HC and NDS (p=0.006, James’s Fj=89.178) and also DS and NDS (p<0.001, James’s Fj=152.967). Shape variability in the form of CC was 0.131, 0.085, 0.082 and 0.086 in the HC, SZ (DS+NDS), DS and NDS groups, respectively.ConclusionsThis study reveals callosal shape variations in patients with SZ and their DS and NDS subgroups that take into account the CC’s topographic distribution.

Does Dysbiosis Increases the Risk of Developing Schizophrenia? - A Comprehensive Narrative Review.

Background: There is increasing evidence of the influence of the intestinal microbiota on the disease processes of various organs and systems. Dysbiosis, that is, alteration of the composition and function of the microbiota may constitute an important risk factor for the development of mental disorders, namely, schizophrenia. Objective: This works aims to review current evidence regarding the pathological mechanisms leading from dysbiosis to schizophrenia and in particular the deficit syndrome in schizophrenia. Methods: Scientific articles from PubMed, SCOPUS, EMBASE and Web of Science Core Collection published between September 2017 and December 2020 were included in this review. Results: The commensal intestinal flora plays an important role in neurodevelopment. In the presence of dysbiosis, this maturation is disturbed, resulting in the modification of brain structures and inflammatory responses at the intestinal, systemic and at the Central Nervous System (CNS) level. These disturbances may be linked to the development of symptoms of the disease. The microbiota exerts its influence on the CNS through several pathways, in this paper we focused on the membrane hypothesis and the inflammatory hypothesis. We explored the evidence concerning the use of probiotics, prebiotics, and fecal transplants. Conclusion: Although there is no consensus regarding the alterations that could constitute a risk factor for schizophrenia, some of the species appear to be more frequently altered and their relationship with the host is dysregulated in patients at risk and with established schizophrenia, particularly in deficit schizophrenia.

A krónikus fájdalom szindrómában szenvedő beteg személyiségjellemzőinek elemzése, különös tekintettel az énerő, önszabályozó és intrapszichés kontrollrendszer vizsgálatára

Háttér: A magyar lakosság több mint egyharmadát érinti e betegség. A vele járó komorbid depresszió a betegek csaknem felénél előfordul. Életvitelükre a rokkantsági állapot jellemző. Rehabilitációs lehetőségeik szűkösek. Tudományosan megalapozott, kidolgozott rehabilitációs program mind ez idáig nem létezik.Célkitűzés: A betegek komplex személyiségvizsgálatán alapuló személyiségi potenciálok feltárása, az int- rapszichés dinamika, életviteli működésmód átfogó elemzése, különös tekintettel a rehabilitációs programtervezés szempontjából döntő „erőfaktorokra", mint énerő, önsegítő-önépítő aktivitás és életviteli kontroll- rendszer.Módszer: A Rorschach komplex és átfogó személyiségvizsgálat alkalmazásával kilenc hipotézis mentén a személyiségjellemzők feltárása, a személyiség egészének kontextusába helyezve az önsegítő, belső erőtényezőkre fókuszált elemzés.Vizsgálati minta: 576 beteg és 609 sine morbo kontrollszemély. Az adatokat SPSS programcsomaggal elemeztük.Eredmények: A betegek sajátos személyiségjellemzői „deficit arculatú" hiánytényezőkként detektálhatók. Ezek közül az önsegítő és önépítő intrapszichés erők, az önkontroll, a motivációs aktivitás súlyos károso- dottsága, valamint az emocionális élet deficitjegyei emelhetők ki. Az életvezetés „deficit szindrómás" mivolta az életminőséget rombolja, és mintegy „életképtelenségi" beteghelyzetet tükröz. Magas megbízhatóságú differenciáldiagnosztikai indexet dolgoztunk ki, amely szűrési és preventív eszközként szolgálhat.Következtetések: Gazdag eredményanyagunk lehetőséget nyit állapot- és betegségspecifikus rehabilitációs program kidolgozására, amelyben a hangsúlyt a belső erőtartalékok, motivációk felerősítésére, énerősítésre és a pozitív copingok megtanítására kell helyeznünk.Background: More than one third of the Hungarian population is affected by chronic pain syndrome, which is accompanied by comorbid depression in almost half the patients. Their lifestyles are peculiar to disability and their rehabilitation opportunities are scarce, but so far, no scientifically based rehabilitation programme has been elaborated.Objective: This study aims to explore personality potentials based on a complex personality assessment of patients and a comprehensive analysis of intrapsychic dynamics and lifestyle, with special regard for strength factors that are crucial for the design of a rehabilitation programme, such as self-empowerment, self-help/self-build activity and the lifestyle control system.Method: Using the Rorschach complex and comprehensive personality survey, this study explores personality traits along ten hypotheses, placed in the context of the whole personality, with a focus on the factors relating to the patients' internal self-help ability.Sample size: 576 patients and 609 “sine morbo” controls. The data were processed with the help of the SPSS statistics software.Results: Patients’ specific personality characteristics can be analysed as deficiency factors that form a "deficit image". These include severe damage to intrapsychic self-help and self-build ability, self-control mechanisms and motivational activity, as well as deficits of emotional life. The patients' lifestyle, which is characteristic of the "deficit syndrome", destroys their quality of life and is thus illustrative of the unviable nature of their situation. We have developed a highly reliable, differential diagnostic index that can serve as a screening and preventive tool.Conclusions: The rich material of our results provides an opportunity for the elaboration of a rehabilitation programme specifically for this conditions/disease, with emphasis on strengthening the patients' inner power reserves, self-motivation and self-empowerment and teaching them positive coping.