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Schizophrenia and frontal cortex: Where does it fail?
Abstract
Schizophrenia is characterized by cognitive, social, and emotional impairments and by psychotic symptoms. Neuroimaging studies have reported abnormalities within the prefrontal cortex and it has been hypothesized that schizophrenia results from poor or miswired anatomical/functional connections. We have compared the functional connectivity within the frontal cortex in control and schizophrenic subjects during the realization of a Continuous Performance Task. The connectivity pattern within the frontal cortex was uncovered by the analysis of the correlation matrix computed from the fMRI time series in frontal areas for 14 schizophrenic patients and 14 control subjects. In control subjects, the right dorsolateral prefrontal cortex (DLFCr) activity correlated i) positively with the left dorsolateral prefrontal cortex and the posterior part of the supplementary motor area, ii) negatively with the medial and anterior/inferior part of the frontal cortex. In the schizophrenic group, these relations were abolished or strongly lowered. The negative relation between the DLFCr and the medial frontal cortex has been proposed to play a key role in setting a harmonious balance between the direction of attention to the external world and the expression of the individual believes and self-referential activities, and therefore, the impaired relation of right DLFCr with other frontal areas could explain a distorted perception of external world in relation with internal motivations.
... Studies performed with functional Magnetic Resonance Imaging (fMRI) and Positron emission tomography (PET) have shown that behavioral (motor response) inhibition is linked to activation of the cortex sites such as a prefrontal cortex (Cohen, Nordahl, Semple, Andreason, & Pickar, 1998), the right VLPFC, a region known to play a critical role in motor response inhibition Epstein, Stern, & Silbersweig, 1999;Kaladjian et al., 2007;Kaladjian et al., 2011) and the DLPFC whose activation negatively correlates with impulsivity (Barch et al., 2001;Brewer et al., 2007;Harrison et al., 2006;MacDonald & Carter, 2003;Perlstein, Dixit, Carter, Noll, & Cohen, 2003;Rubia et al., 2001;Salgado-Pineda et al., 2007;Weiss et al., 2007). However, Mathalon, Jorgensen, Roach, and Ford (2009) found patients to have significantly greater activation in the DLPFC by errors than the controls. ...
... Due to the use of small sample sizes, results of this study should be viewed with caution. In addition, six studies found evidence for right inferior frontal cortex hypoactivations in schizophrenia patients (Krabbendam, O'Daly, Morley, van Os, & Murray, 2009;MacDonald et al., 2005;Perlstein et al., 2003;Salgado-Pineda et al., 2007;Seok Jeong et al., 2005;Siegel et al., 1995). ...
Impulsivity has been repeatedly identified as a major problem in schizophrenia. The literature revealed several ways of defining and conceptualizing impulsivity as well as a variety of measures and an analysis of the consequences of impulsivity. Thus, we review the lack of agreement in the conceptualization and measurement of impulsivity. We also review the latest evidence that impulsivity may have an important role in the etiology of substance use, aggression, violence, and suicide in schizophrenia. In addition, we outline the recent findings in neuroimaging research to elucidating the neurobiological deficits underlying pathological impulsivity in schizophrenia.
... Numerous studies have examined the relationships between the above-mentioned cognitive deficits in patients with schizophrenic disorder and certain dysfunctional patterns of brain activation, especially in the prefrontal areas (Salgado-Pineda et al., 2004;de la Torre et al., 2005;Salgado-Pineda et al., 2007;Minzenberg et al., 2009;Camchong et al., 2011). It is likely that the beneficial effects of new drugs on these cognitive functions would be accompanied by an improvement of these dysfunctional patterns. ...
... We focused on areas of the anterior cingulate that were activated during the execution of a neuroactivation task in the control group of healthy subjects. These areas were observed to be involved in cognitive flexibility in other studies (Moll et al., 2002;Salgado-Pineda et al., 2002;Mulert et al., 2003;Aarts et al., 2009;Badzakova-Trajkov et al., 2009;Hyafil et al., 2009;Ohira et al., 2010;Tana et al., 2010), and there is also evidence of dysfunction in these areas in patients with schizophrenia (Salgado-Pineda et al., 2004;de la Torre et al., 2005;Salgado-Pineda et al., 2007;Camchong et al., 2009;Minzenberg et al., 2009). We controlled for clinical and neuropsychological variables that may have acted as confounding factors. ...
The aim of this study was to examine the changes in cognitive flexibility and associated cerebral blood flow in the anterior cingulate lobe of drug-naive patients with first-episode schizophrenia who were treated with atypical antipsychotics for 6 weeks. Single photon emission computed tomography (SPECT) images were obtained from 8 healthy subjects both at rest and while performing the flexibility subtest of the TAP (Test for Attentional Performance). SPECT images were obtained in parallel from 8 first-episode drug-naive schizophrenic patients while they were performing the same task both before and after 6 weeks of neuroleptic treatment. In the control group, an increase in the perfusion indices of the dorsal section of the anterior cingulate gyrus was observed in the activation condition. Task performance was altered and the level of perfusion of the brain region related to the task execution was significantly decreased in the patients at baseline. After treatment, there was a significant improvement in both task performance and the level of perfusion of the dorsal section of the anterior cingulate. We conclude that treatment with second-generation neuroleptics improves cognitive flexibility, and there was a relationship between such improvements and normalization of perfusion indices of the involved brain areas.
... In this study, we performed ASE analysis on nuclear and cytoplasmic RNA fractions from 3 brain regions (anterior prefrontal cortex, putamen and cerebellar cortex) derived from 4 individuals. These regions were selected as they are anatomically distinct and important to human disease 10,[38][39][40][41][42][43][44][45] . Together this unique sample set was used to investigate the relative importance of nucleus-and cytoplasm-specific processes in the genetic regulation of gene expression across the human brain. ...
Gaining insight into the genetic regulation of gene expression in human brain is key to the interpretation of genome-wide association studies for major neurological and neuropsychiatric diseases. Expression quantitative trait loci (eQTL) analyses have largely been used to achieve this, providing valuable insights into the genetic regulation of steady-state RNA in human brain, but not distinguishing between molecular processes regulating transcription and stability. RNA quantification within cellular fractions can disentangle these processes in cell types and tissues which are challenging to model in vitro. We investigated the underlying molecular processes driving the genetic regulation of gene expression specific to a cellular fraction using allele-specific expression (ASE). Applying ASE analysis to genomic and transcriptomic data from paired nuclear and cytoplasmic fractions of anterior prefrontal cortex, cerebellar cortex and putamen tissues from 4 post-mortem neuropathologically-confirmed control human brains, we demonstrate that a significant proportion of genetic regulation of gene expression occurs post-transcriptionally in the cytoplasm, with genes undergoing this form of regulation more likely to be synaptic. These findings have implications for understanding the structure of gene expression regulation in human brain, and importantly the interpretation of rapidly growing single-nucleus brain RNA-sequencing and eQTL datasets, where cytoplasm-specific regulatory events could be missed.
... As we know, the superior frontal gyrus is located at the superior part of the prefrontal cortex and has been reported to be involved in a wide variety of cognitive and attention tasks (68,69), which is a critical node of the cognitive control network (70). This cortex is associated with decreased cognitive control (71,72) and decreased connectivity with other brain regions in schizophrenia patients (73,74). The supplementary motor cortex participates in the preparation and execution of movements (75,76), while the activation of this region is reduced during a motor task in schizophrenia patients (77) and may reflect the motor dysfunction in schizophrenia (78,79), since motor symptom is one of clinical presentation of schizophrenia and frequently occur throughout the course of this disease (80,81). ...
Background
Auditory verbal hallucinations (AVH) are a core symptom of schizophrenia. Low-frequency (e.g., 1 Hz) repetitive transcranial magnetic stimulation (rTMS) targeting language processing regions (e.g., left TPJ) has been evident as a potential treatment for AVH. However, the underlying neural mechanisms of the rTMS treatment effect remain unclear. The present study aimed to investigate the effects of 1 Hz rTMS on functional connectivity (FC) of the temporoparietal junction area (TPJ) seed with the whole brain in schizophrenia patients with AVH.
Methods
Using a single-blind placebo-controlled randomized clinical trial, 55 patients with AVH were randomly divided into active treatment group (n = 30) or placebo group (n = 25). The active treatment group receive 15-day 1 Hz rTMS stimulation to the left TPJ, whereas the placebo group received sham rTMS stimulation to the same site. Resting-state fMRI scans and clinical measures were acquired for all patients before and after treatment. The seed-based (left TPJ) static and DFC was used to assess the connectivity characteristics during rTMS treatment in patients with AVH.
Results
Overall, symptom improvement following 1 Hz rTMS treatment was found in the active treatment group, whereas no change occurred in the placebo group. Moreover, decreased static FC (SFC) of the left TPJ with the right temporal lobes, as well as increased SFC with the prefrontal cortex and subcortical structure were observed in active rTMS group. Increased dynamic FC (DFC) of the left TPJ with frontoparietal areas was also found in the active rTMS group. However, seed-based SFC and DFC were reduced to a great extent in the placebo group. In addition, these changed FC (SFC) strengths in the active rTMS group were associated with reduced severity of clinical outcomes (e.g., positive symptoms).
Conclusion
The application of 1 Hz rTMS over the left TPJ may affect connectivity characteristics of the targeted region and contribute to clinical improvement, which shed light on the therapeutic effect of rTMS on schizophrenia with AVH.
... Global brain functional connectivity in the left SFG was increased in subjects with schizophrenia and their unaffected siblings 48 . In the activity of the right and left DLPFC, the posterior part of the SMA was abolished or reduced in subjects with schizophrenia 49 , which was also the case in this study. Researchers have shown that these brain areas are involved in speech and language processing 50,51 , and they contain motor plan and control 52 and attentional switching and inner speech during language encoding 53 . ...
It is widely accepted that there are some common network patterns in the human brain. However, the existence of stable and strong functional connections in the human brain and whether they change in schizophrenia is still a question. By setting 1% connections with the smallest coefficient of variation, we found a widespread brain functional network (frame network) in healthy people(n = 380, two datasets from public databases). We then explored the alterations in a medicated group (60 subjects with schizophrenia vs 71 matched controls) and a drug-naive first-episode group (68 subjects with schizophrenia vs 45 matched controls). A linear support vector classifier (SVC) was constructed to distinguish patients and controls using the medicated patients’ frame network. We found most frame connections of healthy people had high strength, which were symmetrical and connected the left and right hemispheres. Conversely, significant differences in frame connections were observed in both patient groups, which were positively correlated with negative symptoms (mainly language dysfunction). Additionally, patients’ frame network were more left-lateralized, concentrating on the left frontal lobe, and was quite accurate at distinguishing medicated patients from controls (classifier accuracy was 78.63%, sensitivity was 86.67%, specificity was 76.06%, and the area under the curve (AUC) was 0.83). Furthermore, the results were repeated in the drug-naive set (accuracy was 84.96%, sensitivity was 85.29%, specificity was 88.89%, and AUC was 0.93). These findings indicate that the abnormal pattern of frame network in subjects with schizophrenia might provide new insights into the dysconnectivity in schizophrenia.
... MIA induced by LPS treatment mimics infection with Gram-negative bacteria [35], while that elicited by Poly I:C is similar to the acute phase response to viral infection [36]. In the offspring at postnatal day 7 (PND7), we examined the impact of MIA on the mRNA and protein expression of CX3CL1, CD200 and their receptors in the hippocampus and frontal cortex, which are areas of the brain distinctly affected in schizophrenia [37,38]. Moreover, we visualized the localization of ligand-receptor systems in hippocampal regions (CA1, CA3 and DG) and the frontal cortex after MIA. ...
Background:
The bidirectional communication between neurons and microglia is fundamental for the homeostasis and biological function of the central nervous system. Maternal immune activation (MIA) is considered to be one of the factors affecting these interactions. Accordingly, MIA has been suggested to be involved in several neuropsychiatric diseases, including schizophrenia. The crucial regulatory systems for neuron-microglia crosstalk are the CX3CL1-CX3CR1 and CD200-CD200R axes.
Methods:
We aimed to clarify the impact of MIA on CX3CL1-CX3CR1 and CD200-CD200R signalling pathways in the brains of male Wistar rats in early and adult life by employing two neurodevelopmental models of schizophrenia based on the prenatal challenge with lipopolysaccharide (LPS) and polyinosinic:polycytidylic acid (Poly I:C). We also examined the effect of MIA on the expression of microglial markers and the profile of cytokines released in the brains of young offspring, as well as the behaviour of adult animals. Moreover, we visualized the localization of ligand-receptor systems in the hippocampal regions (CA1, CA3 and DG) and the frontal cortex of young rats exposed to MIA. The differences between groups were analysed using Student's t test.
Results:
We observed that MIA altered developmental trajectories in neuron-microglia communication in the brains of young offspring, as evidenced by the disruption of CX3CL1-CX3CR1 and/or CD200-CD200R axes. Our data demonstrated the presence of abnormalities after LPS-induced MIA in levels of Cd40, Il-1β, Tnf-α, Arg1, Tgf-β and Il-10, as well as IBA1, IL-1β and IL-4, while after Poly I:C-generated MIA in levels of Cd40, iNos, Il-6, Tgf-β, Il-10, and IBA1, IL-1β, TNF-α, IL-6, TGF-β and IL-4 early in the life of male animals. In adult male rats that experienced prenatal exposure to MIA, we observed behavioural changes resembling a schizophrenia-like phenotype.
Conclusions:
Our study provides evidence that altered CX3CL1-CX3CR1 and/or CD200-CD200R pathways, emerging after prenatal immune challenge with LPS and Poly I:C, might be involved in the aetiology of schizophrenia.
... As long-term neuro-inflammatory alterations are associated with schizophrenia, and have been identified as a potential mediating mechanisms between maternal immune activation and schizophrenia-related neurodevelopmental disruption (Na et al., 2014), the current study assessed astrocytes and microglia using immunohistochemistry within the CC and frontal WM, areas of the brain strongly implicated in schizophrenia (Lewis and Levitt, 2002;Pomarol-Clotet et al., 2010;Salgado-Pineda et al., 2007;Wible et al., 2001). We observed subtle effects of maternal immune activation on GFAP+ immunoreactivity, but not mRNA, only in the CC (not WM) with pairwise comparisons showing an increase in GFAP+IRM which approached significance in GD19 but not GD10 PolyI:C rats. ...
Animal models of maternal immune activation study the effects of infection, an environmental risk factor for schizophrenia, on brain development. Microglia activation and cytokine upregulation may have key roles in schizophrenia neuropathology. We hypothesised that maternal immune activation induces changes in microglia and cytokines in the brains of the adult offspring. Maternal immune activation was induced by injecting polyriboinosinic:polyribocytidylic acid into pregnant rats on gestational day (GD) 10 or GD19, with brain tissue collected from the offspring at adulthood. We observed no change in Iba1, Gfap, IL1-β and TNF-α mRNA levels in the cingulate cortex (CC) in adult offspring exposed to maternal immune activation. Prenatal exposure to immune activation had a significant main effect on microglial IBA1-positive immunoreactive material (IBA1+IRM) in the corpus callosum; post-hoc analyses identified a significant increase in GD19 offspring, but not GD10. No change in was observed in the CC. In contrast, maternal immune activation had a significant main effect on GFAP+IRM in the CC at GD19 (not GD10); post-hoc analyses only identified a strong trend towards increased GFAP+IRM in the GD19 offspring, with no white matter changes. This suggests late gestation maternal immune activation causes subtle alterations to microglia and astrocytes in the adult offspring.
... Poly I:C was injected into pregnant C57BL/6 mice at embryonic day (E)9.5 (Meyer et al., 2008;Hsiao et al., 2012;Khan et al., 2014;Zhu et al., 2014;Giovanoli et al., 2016b). The prefrontal cortex, hippocampus, and cerebellum, regions where structural and functional alterations were mainly described in schizophrenia patients (Harrison, 2004;Salgado-Pineda et al., 2007;Picard et al., 2008), were selected for analysis. ...
Epidemiological studies revealed that environmental factors comprising prenatal infection are strongly linked to risk for later development of neuropsychiatric disorders such as schizophrenia. Considering strong sex differences in schizophrenia and its increased prevalence in males, we designed a methodological approach to investigate possible sex differences in pathophysiological mechanisms. Prenatal immune challenge was modeled by systemic administration of the viral mimic polyinosinic-polycytidylic acid (Poly I:C) to C57BL/6 mice at embryonic day 9.5. The consequences on behavior, gene expression, and microglia-brain immune cells that are critical for normal development-were characterized in male vs. female offspring at adulthood. The cerebral cortex, hippocampus, and cerebellum, regions where structural and functional alterations were mainly described in schizophrenia patients, were selected for cellular and molecular analyses. Confocal and electron microscopy revealed most pronounced differences in microglial distribution, arborization, cellular stress, and synaptic interactions in the hippocampus of male vs. female offspring exposed to Poly I:C. Sex differences in microglia were also measured under both steady-state and Poly I:C conditions. These microglial alterations were accompanied by behavioral impairment, affecting for instance sensorimotor gating, in males. Consistent with these results, increased expression of genes related to inflammation was measured in cerebral cortex and hippocampus of males challenged with Poly I:C. Overall, these findings suggest that schizophrenia's higher incidence in males might be associated, among other mechanisms, with an increased microglial reactivity to prenatal immune challenges, hence determining disease outcomes into adulthood.
... In particular, the DLPFC plays an important role in the executive control and working memory (Ceaser, 2013;Potkin et al., 2009). These results are consonant with common features of schizophrenia, such as the difficulty of prioritizing, processing, and responding to information (Salgado-Pineda et al., 2007), and confirm the frontal inefficiency related to the pathology (Catani et al., 2012;Sheffield and Barch, 2016). Other reported characteristics of schizophrenia are impaired control of empathy towards other people and impaired visual perception (Bonfils et al., 2016;Bora et al., 2008;Zhu et al., 2015), which may be related to abnormal CBF in the SMG and in occipital regions (Butler et al., 2008;Ota et al., 2014a;Silani et al., 2013), respectively. ...
Schizophrenia is a severe mental disorder that affects the anatomy and function of the brain, with an impact on one's thoughts, feelings, and behavior. The purpose of the study was to investigate cerebral blood flow (CBF) and brain connectivity in a group of patients with schizophrenia. Pseudo-continuous arterial spin labeling (pCASL) images were acquired from 28 patients in treatment and 28 age-matched healthy controls. Mean CBF and connectivity patterns were assessed. Schizophrenia patients had decreased CBF in the bilateral frontal pole and superior frontal gyrus, right medial frontal gyrus, triangular and opercular parts of the inferior frontal gyrus, posterior division of the left supramarginal gyrus, superior and inferior divisions of the left lateral occipital cortex, and bilateral occipital pole. Moreover, through different methods to assess connectivity, our results showed abnormal connectivity patterns in regions involved in motor, sensorial, and cognitive functions. Using pCASL, a non-invasive technique, we found CBF deficits and altered functional organization of the brain in schizophrenia patients that are associated with the symptoms and characteristics of the disorder.
... Convergent findings of decreased rCBF were reported in the frontal lobe (FL), left middle frontal gyrus (eMiFG), and inferior frontal gyrus (IFG). These regions are closely related to the regulation of complex behaviors that are impaired in schizophrenia 16 . Pinkham et al. 17 found a frontal region with increased rCBF, the right precentral gyrus, but no explanation was given for this finding and no other study in our review found similar results in this region or in any other frontal region. ...
Background:
Neuroimaging studies are an invaluable source of information about the physiopathology of schizophrenia. Arterial spin labeling (ASL) is a new magnetic resonance technique (MRI) that is able to effectively evaluate brain function without the use of radiation.
Objective:
To make a systematic review of studies using ASL to compare resting-state regional cerebral blood flow (rCBF) patterns in patients with schizophrenia and healthy controls.
Methods:
Original articles were searched for on PubMed, Scopus, Web of Science and PsycINFO electronic databases. The search terms used were ‘arterial’, ‘spin’, ‘labeling’, and ‘schizophrenia’. Only studies comparing resting-state rCBF were included, a qualitative synthesis was then performed.
Results:
Ten articles were included in the review among a total of 22. Decreased rCBF in schizophrenia patients was described in the anterior cingulate, cuneus, fusiform gyrus, frontal lobe, left middle frontal gyrus, inferior frontal gyrus, lingual gyrus, middle occipital gyrus, and parietal lobe. The putamen was the only region with increased rCBF in schizophrenia.
Discussion:
The evidence of the studies reviewed lends support to the concept of hipofrontality in schizophrenia. rCBF alterations were found in regions classically associated with schizophrenia. ASL seems to be valid, and reliable tool to assess schizophrenia.
... PRKCE is involved in nerve growth factor (NFG)-induced neurite outgrowth and neuron morphological change. CNTNAP2 may play a major role in the formation of functionally distinct domains critical for saltatory conduction of nerve impulses in myelinated nerve fibers and, therefore, its epigenetic alteration is consistent with the hypothesis that schizophrenia results from poor or miswired anatomical or functional connections (Salgado-Pineda et al., 2007). ...
Attempts to discover genes that are involved in the pathogenesis of major psychiatric disorders have been frustrating and often fruitless. Concern is building about the need to understand the complex ways in which nature and nurture interact to produce mental illness. We analyze the epigenome in several brain regions from schizophrenic patients with severe cognitive impairment using high-resolution (450K) DNA methylation array. We identified 139 differentially methylated CpG sites included in known and novel candidate genes sequences as well as in and intergenic sequences which functions remain unknown. We found that altered DNA methylation is not restricted to a particular region, but includes others such as CpG shelves and gene bodies, indicating the presence of different DNA methylation signatures depending on the brain area analyzed. Our findings suggest that epimutations are not relatables between different tissues or even between tissues' regions, highlighting the need to adequately study brain samples to obtain reliable data concerning the epigenetics of schizophrenia.
... The current results suggest that a blatant failure to inhibit the correct response reflects more general cognitive process captured by standard cognitive measures, whereas subtle response errors may reflect specific processes involving right lateral frontal cortex. Strong evidence exists for right prefrontal cortex dysfunction in the pathogenesis of schizophrenia and associated cognitive deficits (Kaladjian et al., 2007;Kim et al., 2003;Martin, Robinson, Reutens, & Mowry, 2014;Salgado-Pineda et al., 2007). The exact nature of these processes is unknown but a failure to adopt a strategy on the HSCT in individuals with schizophrenia is similar to that observed in right lateral frontal patients, further implicating this region in schizophrenia pathology. ...
Objectives:
Individuals with schizophrenia have difficulties on measures of executive functioning such as initiation and suppression of responses and strategy development and implementation. The current study thoroughly examines performance on the Hayling Sentence Completion Test (HSCT) in individuals with schizophrenia, introducing novel analyses based on initiation errors and strategy use, and association with lifetime clinical symptoms.
Methods:
The HSCT was administered to individuals with schizophrenia (N=77) and age- and sex-matched healthy controls (N=45), along with background cognitive tests. The standard HSCT clinical measures (initiation response time, suppression response time, suppression errors), composite initiation and suppression error scores, and strategy-based responses were calculated. Lifetime clinical symptoms [formal thought disorder (FTD), positive, negative] were calculated using the Lifetime Dimensions of Psychosis Scale.
Results:
After controlling for baseline cognitive differences, individuals with schizophrenia were significantly impaired on the suppression response time and suppression error scales. For the novel analyses, individuals with schizophrenia produced a greater number of initiation errors and subtly wrong errors, and produced fewer responses indicative of developing an appropriate strategy. Strategy use was negatively correlated with FTD symptoms in individuals with schizophrenia.
Conclusions:
The current study provides further evidence for deficits in the initiation and suppression of verbal responses in individuals with schizophrenia. Moreover, an inability to attain a strategy at least partly contributes to increased semantically connected errors when attempting to suppress responses. The association between strategy use and FTD points to the involvement of executive deficits in disorganized speech in schizophrenia. (JINS, 2016, 22, 1-9).
... This is the case of midline cortical regions showing abnormal pattern of activity (Harrison, Yücel, Pujol, & Pantelis, 2007) or of the prefrontal cortex presenting a smaller grey matter volume (Sapara et al., 2007) in schizophrenic patients by comparison with healthy subjects. Moreover, relations between the right dorsolateral prefrontal cortex and the medial frontal cortex, two regions playing important functional role in self-consciousness (see Northoff & Bermpohl, 2004), seem to be strongly lowered or even abolished in schizophrenic patients (Salgado-Pineda et al., 2007). ...
... Recently, a different version of CPT, corresponding to the 1-back working memory task, was used to investigate the functional connectivity within the frontal cortex of schizophrenia patients, reporting specific functional disconnectivity between right DLPFC and other frontal regions (Salgado-Pineda et al., 2007). A spectral reordering algorithm was used to separate groups of regions of interest (ROIs) in frontal cortex by reordering (i.e., a permutation of the rows and the column) the correlation matrix of the time-series of the ROIs, so that groups of ROIs with high correlations appear in the reordered matrix. ...
... Rightlateralized DLPFC function is thought to play a role in memory retrieval (76,77) and cognitive control (78,79). Estimates of right DLPFC functional connectivity derived from fMRI studies show reduced interactions between this region in patients with SZ across a wide range of cognitive tasks (80,81). Our data suggest that a relationship between right DLPFC functional connectivity and cognition might also be present in the resting-state of the brain, indicating a potential treatment target (82). ...
Background: Schizophrenia (SZ) is associated with functional decoupling between cortical regions, but we do not know whether and where this occurs in low-frequency electromagnetic oscillations. The goal of this study was to use magnetoencephalography (MEG) to identify brain regions that exhibit abnormal resting-state connectivity in the alpha frequency range in patients with schizophrenia and investigate associations between functional connectivity and clinical symptoms in stable outpatient participants.
... Estudios más recientes centran sus esfuerzos en encontrar anomalías en distintas áreas cerebrales: algunas investigaciones han revelado conexiones anormales entre las áreas frontales y estructuras corticales y subcorticales [70], y han llegado incluso a postular que la relación dañada entre el córtex prefrontal dorsolateral derecho y otras áreas frontales podría estar relacionada con falsas creencias, ideación delirante y percepción distorsionada del mundo externo [71]. Otros sugieren que la conectividad del córtex prefrontal dorsolateral con el área temporal podría subyacer a los déficit en la codificación de las palabras [72]. ...
Neuroimaging of psychiatric disorders, especially on schizophrenia, has been increased in the last decade. Different brain imaging techniques have become a useful tool to discover the pathophysiology of schizophrenia.
To describe scientific and historical background of neuroimaging in psychiatry, and to describe the current structural, functional and neurochemical findings in schizophrenia using brain imaging techniques, and their potential disadvantages.
This review synthesizes our current knowledge on the neurobiology of psychosis, reviewing studies including structural (magnetic resonance imaging, diffusion tensor imaging), functional (PET and SPECT, functional magnetic resonance imaging) and neurochemical/transmission (neurochemical PET and SPECT, magnetic resonance spectroscopy) neuroimaging techniques on schizophrenia.
Cognitive impairment, structural and functional disturbances, dopaminergic hypothesis, white matter changes, and any other findings, have been reported. Nevertheless, there are still many doubts and discrepancies to solve, regarding to neuroimaging in schizophrenia. Coupling multimodal imaging with genetics and pharmacotherapeutic studies will further assist in understanding the pathophysiology of schizophrenia.
... Such an effect found only in the patient group even when HVLT-delayed scores were not significantly different between the two groups suggests that this relationship between DLPFC connectivity and verbal memory is specific to schizophrenia . Active-state fMRI studies have shown that the functional connections of this region in the right hemisphere, in Brodmann's Area 9 of the middle frontal gyrus, are reduced in schizophrenia during various cognitive tasks such as movement sequencing and continuous performance (Salgado-Pineda et al., 2007; Woodward et al., 2009). Resting-state functional connectivity scores were also related to performance during a category fluency test, where subjects are required to verbally produce words in a specified category. ...
The cognitive dysfunction present in patients with schizophrenia is thought to be driven in part by disorganized connections between higher-order cortical fields. Although studies utilizing electroencephalography (EEG), PET and fMRI have contributed significantly to our understanding of these mechanisms, magnetoencephalography (MEG) possesses great potential to answer long-standing questions linking brain interactions to cognitive operations in the disorder. Many experimental paradigms employed in EEG and fMRI are readily extendible to MEG and have expanded our understanding of the neurophysiological architecture present in schizophrenia. Source reconstruction techniques, such as adaptive spatial filtering, take advantage of the spatial localization abilities of MEG, allowing us to evaluate which specific structures contribute to atypical cognition in schizophrenia. Finally, both bivariate and multivariate functional connectivity metrics of MEG data are useful for understanding how these interactions in the brain are impaired in schizophrenia, and how cognitive and clinical outcomes are affected as a result. We also present here data from our own laboratory that illustrates how some of these novel functional connectivity measures, specifically imaginary coherence (IC), are quite powerful in relating disconnectivity in the brain to characteristic behavioral findings in the disorder.
... Specifically, functional connectivity analysis revealed two salient features of the altered right dlPFC activity observed in patients and unaffected siblings: 1) overall connectivity between dlPFC and multiple brain regions is reduced, and 2) the association between connectivity in a right fronto-parietal network and task performance is different for patients and unaffected siblings. Reduced connectivity between the dlPFC and other brain areas, particularly posterior brain regions, is emerging as a consistent finding in imaging studies of schizophrenia and the present study extends the work in patients to unaffected siblings (Courtney et al., 1997;Williamson, 2007;Garrity et al., 2007;Salgado-Pineda et al., 2007;Zhou et al., 2007;Pomarol-Clotet et al., 2008;Yoon et al., 2008). Indeed, there is considerable evidence that fronto-parietal dysconnection contributes to a variety aspects of schizophrenia, including impaired cognition (Torrey, 2007). ...
The search for genes conferring liability for schizophrenia may be aided by the identification of endophenotypes. Response selection is a heritable cognitive function that is impaired in patients with schizophrenia and their unaffected siblings. The abnormalities in cerebral function that presumably underlie the deficit in patients and unaffected siblings remain to be elucidated. Cerebral neurophysiology during performance of a 4-choice reaction time (CRT) task in 25 patients with schizophrenia (15 medication free first episode (FEP) and 10 chronic patients), 32 controls, and 12 unaffected siblings of individuals with schizophrenia was investigated using fMRI. CRT was impaired in both medication free FEP and chronic patients with schizophrenia, and unaffected siblings. FEP patients, chronic patients, and unaffected siblings demonstrated greater BOLD response in the right dorsolateral prefrontal cortex (dlPFC) during CRT task blocks. The nature of the altered activation in the dlPFC was further examined using functional connectivity analysis. This revealed marked reductions in connectivity between the right dlPFC and multiple brain regions in both patient groups and, to a lesser degree, unaffected siblings. The magnitude of connectivity between right dlPFC and inferior parietal lobule correlated with task performance in the combined patient/unaffected siblings group, but not controls suggesting that the network of brain regions recruited to perform the task differed as a function of genetic liability for schizophrenia. The findings suggest that altered activity and connectivity of the right dlPFC appears to be related to genetic vulnerability for schizophrenia and may represent a potential endophenotype of the disorder.
... 1,2 Furthermore the organizational deficit might indicate the prefrontal dysfunction frequently observed in these patients. 30,31 We also examined whether organizational deficit mediates visual memory impairment among patients with schizophrenia. In other words, we scrutinized whether the poor visual memory exhibited by patients with schizophrenia on the ROCF was caused by poor organizational strategy during copying, rather than a true memory dysfunction. ...
The aim of the present study was to examine how copy organization mediated immediate recall among patients with schizophrenia using the Rey-Osterrieth Complex Figure Test (ROCF).
The Boston Qualitative Scoring System (BQSS) was applied for qualitative and quantitative analyses of ROCF performances. Subjects included 20 patients with schizophrenia and 20 age- and gender-matched healthy controls.
During the copy condition, the schizophrenia group and the control group differed in fragmentation; during the immediate recall condition, the two groups differed in configural presence and planning; and during the delayed recall condition, they differed in several qualitative measurements, including configural presence, cluster presence/placement, detail presence/placement, fragmentation, planning, and neatness. The two groups also differed in several quantitative measurements, including immediate presence and accuracy, immediate retention, delayed retention, and organization. Although organizational strategies used during the copy condition mediated the difference between the two groups during the immediate recall condition, group also had a significant direct effect on immediate recall.
Schizophrenia patients are deficient in visual memory, and a piecemeal approach to the figure and organizational deficit seem to be related to the visual memory deficit. But schizophrenia patients also appeared to have some memory problems, including retention and/or retrieval deficits.
... Therefore, a separate investigation of the thalamic subregions related to these two cortical regions is necessary rather than regarding them as a single prefrontal-related thalamic subregion as was examined in the previous study (Behrens et al., 2003). Since the abnormal dorsolateral prefrontal functions including working memory impairment and executive dysfunctions have been considered to be a basis of a variety of deficit symptoms in schizophrenia (Kim et al., 2003;Salgado-Pineda et al., 2007), we can expect the connectivity-based approach to reveal abnormalities in the dorsolateral prefrontal-related thalamic subregion. ...
The thalamus, which consists of multiple subnuclei, has been of particular interest in the study of schizophrenia. This study aimed to identify abnormalities in the connectivity-based subregions of the thalamus in patients with schizophrenia.
Thalamic volume was measured by a manual tracing on superimposed images of T1-weighted and diffusion tensor images in 30 patients with schizophrenia and 22 normal volunteers. Cortical regional volumes automatically measured by a surface-based approach and thalamic subregional volumes measured by a connectivity-based technique were compared between the two groups and their correlations between the connected regions were calculated in each group.
Volume reduction was observed in the bilateral orbitofrontal cortices and the left cingulate gyrus on the cortical side, whereas in subregions connected to the right orbitofrontal cortex and bilateral parietal cortices on the thalamic side. Significant volumetric correlations were identified between the right dorsal prefrontal cortex and its related thalamic subregion and between the left parietal cortex and its related thalamic subregion only in the normal group.
Our results suggest that patients with schizophrenia have a structural deficit in the corticothalamic systems, especially in the orbitofrontal-thalamic system. Our findings may present evidence of corticothalamic connection problems in schizophrenia.
At the moment, the study of the association of different brain areas with schizophrenia is a thriving field of research. Although the precise mechanisms underlying the development of schizophrenia remain not fully understood, ongoing research enhances our understanding of which areas of the brain may be associated with various symptoms and behavioral disturbances in patients with the disease. Pathological changes in the brain may be accompanied by a decrease in the level of myelin. The results obtained in the present study support the hypothesis of an association between brain myelination and the development of schizophrenia. The present study revealed reduced myelination in the number of areas which can be divided into several groups based on common features. In our work, significant changes were found in the following areas of the brain: Heschl’s Gyrus (includes H1 and H2), Postcentral Gyrus, Lateral Occipital Cortex superior division, Frontal Pole, Paracingulate Gyrus, Inferior frontal gyrus, Middle frontal gyrus. In the future, the results of the study can be used to create a non-invasive quantitative marker of schizophrenia. This will allow, on the one hand, to characterize the current stage of the disease of a particular patient in terms of myelination abnormalities, and on the other hand, it can help shed light on the etiology of this disease.
Although the precise mechanisms and pathways of schizophrenia remain something of a mystery, there is little dispute that cognitive deficits present as some of the clearest and most debilitating symptoms of the disease. This book describes the characteristics of cognitive deficits in schizophrenia, functional implications, the course of impairments, the genetic and biological contributions and reviews management options, including neuropsychological, psychological and pharmacological techniques. Chapters are written by leading experts in the field, in an accessible and highly informative style, ensuring the content is clinically relevant. State-of-the-art information about new developments in the treatment of related features of the illness, such as disability, is provided. The wide ranging focus of this volume will appeal to clinicians and academic researchers working with patients impaired by severe mental illness.
Introduction: Schizophrenia is a clinical construct comprising manifold phenotypes underlying heterogeneous biological underpinnings. The Positive and Negative Syndrome Scale (PANSS) represents the standard tool in the clinical characterization of patients affected by schizophrenia, allowing to detect different clinical profiles within the disorder. Frontal lobes are a key area of brain dysfunction in schizophrenia. We investigated whether different clinical profiles in acute schizophrenia show differences in frontal lobes dysfunction or not.
Methods: We defined PANSS-derived principal components in a sample of 516 acute patients. These components were used as clustering variables in a finite-mixture model. Frontal lobe impairment, measured with the frontal assessment battery (FAB) score, was adjusted for disease duration and compared across the clinical clusters with ANCOVA. A supervised-learning approach was then implemented to reveal most informative PANSS items.
Results: A three-cluster solution emerged: a first profile with high-moderate expression for the positive and excitability/hostility component; a second profile scoring high on depression/anxiety and low on other components; a third profile, comprising the majority of the study population (74%), with a heavy affection on the negative-disorganization dimensions. After controlling for disease duration, frontal lobe impairment significantly differed across the aforementioned clusters, with the third cluster being the most affected. Two PANSS items presented the highest predictive value for FAB total score.
Conclusions: Among negative and disorganization symptoms, “difficulty in abstract thinking” and “lack of spontaneity /flow in conversation” are specifically mapped to higher levels of frontal lobes dysfunction, hinting at similar features with other neurological disorders involving frontal lobes.
Schizophrenia is a disabling psychiatric disorder that affects around 1% of the population worldwide. Delusions, hallucinations, disorganized thought, and cognitive deficits are the main features of schizophrenia. Physiologically, in addition to functional and structural abnormalities, changes in neuronal activity are reported. Since the Cerebral Blood Flow (CBF) is directly related with neuronal activity, the Magnetic Resonance Imaging (MRI) technique called Arterial Spin Labeling (ASL), which allows the quantification of CBF, is a useful tool in brain functional evaluation. In addition, ASL can be used to assess functional connectivity, which is efficient in investigating functional impairment between regions of the brain. Patients with Schizophrenia, recruited at the Clinical Hospital (HCFMRP), presented a reduction of CBF in bilateral regions of the frontal pole and superior frontal gyrus, right medial frontal gyrus, triangular and opercular parts of the right inferior frontal gyrus, posterior division of left supramarginal gyrus, superior and inferior division of left lateral occipital cortex and occipital pole. Functional connectivity, assessed by three different methods (seed-based, independent component analysis and graph theory), was impaired in regions involving patients' motor, sensory and cognitive functions. Therefore, using a noninvasive imaging technique, it was possible to observe CBF deficits and alterations in the functional organization of the brain of schizophrenia patients, related to the symptoms and characteristics of the psychopathology.
This is the fourth edition of the undisputed classic on the prefrontal cortex, the principal "executive" structure of the brain. Because of its role in such cognitive functions as working memory, planning, and decision-making, the prefrontal cortex is critically involved in the organization of behavior, language, and reasoning. Prefrontal dysfunction lies at the foundation of several psychotic and neurodegenerative disorders, including schizophrenia and dementia. * Written by an award-winning author who discovered "memory cells"-the physiological substrate of working memory * Provides an in-depth examination of the contributions of every relevant methodology, from comparative anatomy to modern imaging * Well-referenced with more than 2000 references.
Schizophrenia (SZ) is associated with functional decoupling between cortical regions, but we do not know whether and where this occurs in low-frequency electromagnetic oscillations. The goal of this study was to use magnetoencephalography (MEG) to identify brain regions that exhibit abnormal resting-state connectivity in the alpha frequency range in patients with schizophrenia and investigate associations between functional connectivity and clinical symptoms in stable outpatient participants.
Thirty patients with SZ and 15 healthy comparison participants were scanned in resting-state MEG (eyes closed). Functional connectivity MEG source data were reconstructed globally in the alpha range, quantified by the mean imaginary coherence between a voxel and the rest of the brain.
In patients, decreased connectivity was observed in left prefrontal cortex (PFC) and right superior temporal cortex, whereas increased connectivity was observed in left extrastriate cortex and the right inferior PFC. Functional connectivity of left inferior parietal cortex was negatively related to positive symptoms. Low left PFC connectivity was associated with negative symptoms. Functional connectivity of midline PFC was negatively correlated with depressed symptoms. Functional connectivity of right PFC was associated with other (cognitive) symptoms.
This study demonstrates direct functional disconnection in SZ between specific cortical fields within low-frequency resting-state oscillations. Impaired alpha coupling in frontal, parietal, and temporal regions is associated with clinical symptoms in these stable outpatients. Our findings indicate that this level of functional disconnection between cortical regions is an important treatment target in SZ.
Functional neuroimaging studies carried out on healthy volunteers while performing different n-back tasks have shown a common pattern of bilateral frontoparietal activation, especially of the dorsolateral prefrontal cortex (DLPFC). Our objective was to use functional magnetic resonance imaging (fMRI) to compare the pattern of brain activation while performing two similar n-back tasks which differed in their presentation modality. Thirteen healthy volunteers completed a verbal 2-back task presenting auditory stimuli, and a similar 2-back task presenting visual stimuli. A conjunction analysis showed bilateral activation of frontoparietal areas including the DLPFC. The left DLPFC and the superior temporal gyrus showed a greater activation in the auditory than in the visual condition, whereas posterior brain regions and the anterior cingulate showed a greater activation during the visual than during the auditory task. Thus, brain areas involved in the visual and auditory versions of the n-back task showed an important overlap between them, reflecting the supramodal characteristics of working memory. However, the differences found between the two modalities should be considered in order to select the most appropriate task for future clinical studies.
The purpose of the present study was to characterize the association between clinical symptoms and anatomical and functional cerebral deficits in a relatively large sample of antipsychotic-naive first-episode schizophrenia patients using optimized voxel-based morphometry and resting state functional connectivity analysis.
Participants were 68 antipsychotic-naive first-episode schizophrenia patients and 68 matched healthy comparison subjects. Both patients and healthy comparison subjects were scanned using a volumetric three-dimensional spoiled gradient recall sequence and a gradient-echo echo-planar imaging sequence. Psychopathology of first-episode schizophrenia patients was evaluated using the Positive and Negative Syndrome Scale (PANSS). Optimized voxel-based morphometry was used to characterize gray matter deficits in schizophrenia patients. The clinical significance of regional volume reduction was investigated by examining its association with symptoms in patients with first-episode schizophrenia and with alterations in resting state functional connectivity when brain regions with gray matter volume reduction were used as seed areas.
Significantly decreased gray matter volume was observed in schizophrenia patients in the right superior temporal gyrus (Brodmann's area 41), right middle temporal gyrus (Brodmann's area 21), and right anterior cingulate gyrus (Brodmann's area 32). Decreased gray matter volume in these brain regions was related to greater disturbance as shown on PANSS scores for positive symptoms, general psychopathology symptoms, thought disturbance, activation, paranoia, and impulsive aggression as well as total PANSS scores. A positive correlation was observed between PANSS scores for thought disturbance and temporo-putamen connectivity, and negative correlations were found between temporo-precuneus connectivity and total PANSS scores as well as scores for negative symptoms and anergia.
The findings revealed volume loss in the right superior temporal gyrus, right middle temporal gyrus, and right anterior cingulate gyrus among antipsychotic-naive first-episode schizophrenia patients. In addition, the functional networks involving the right superior temporal gyrus and middle temporal gyrus were associated with clinical symptom severity. No abnormalities were observed in resting state connectivity with regions of identified gray matter deficits.
The role of the frontal lobe in cross-modal visual-auditory processing has been documented in experiments using incongruent/congruent paradigms. In this study, 4 patients with left frontal World Health Organization Grade II glioma were assessed during pre-, intra-, and postoperative sessions with picture-naming and verbal-visual task requiring judgment of congruence between pictures and words. During awake brain surgery, the naming and cross-modal tasks were coupled with electrical stimulation inactivating restricted specific regions. For all patients, focal brain stimulation in the dorsolateral prefrontal cortex elicited picture-word matching disturbances but no naming impairment, and the elicited errors exclusively appeared in incongruent and not congruent conditions. The dissociation observed between correct picture naming and disturbed cross-modal judgment shows that electrical stimulation of a discrete cortical area within the left dorsolateral prefrontal cortex can inhibit the simultaneous processing of visual-verbal information without disturbing larger networks involved in the naming process.
The corpus callosum (CC) is of great interest for pathophysiological models of schizophrenia. Volume and structural integrity of the CC have been examined by volumetric and diffusion tensor imaging (DTI) studies, but results were not consistent across methods or studies. A possible explanation may be varying methodologies and accuracy of measurements based on a single slice or small regions of interest. In addition, none of the studies examined volume and diffusion values in the same group of patients, and thus the relationship between these anatomical measures is not clear. We used an automatic algorithm to segment seven midline slices of the CC from DTI images. We compared volume and the DTI measures fractional anisotropy (FA) and mean diffusivity (MD) in the CC and its subdivisions in the schizophrenia patients and matched controls. Patients had decreased volume, decreased FA and increased MD of the whole CC. The important novel finding is, however, that not all regions were equally affected by anatomical changes. The results emphasize the importance of using different methods in evaluation of white matter (WM) in schizophrenia to avoid false negative findings. In addition, the measures were highly correlated with each other, implying a common pathological process influencing FA, MD and volume of the CC. Although we cannot rule out other mechanisms affecting volume, FA and MD, converging evidence from cytoarchitectonic and genetic studies suggests that WM changes observed in schizophrenia may involve disintegration of healthy, functional axons and strengthening of aberrant connections resulting in increased severity of clinical symptoms.
This review focuses on neuroimaging studies that address the relationship between selective attention, neural activity and visual awareness. Withdrawing attention from particular visual stimuli reduces modality-specific processing in posterior visual cortex, and when attention is fully engaged elsewhere, even highly salient but task-irrelevant stimuli can fail to evoke activity and reach awareness. However, the link between visual attention and awareness extends beyond posterior visual cortex to also encompass regions of parietal and prefrontal cortex. Activity in the posterior visual cortex may be necessary but not sufficient for awareness, without a contribution from frontal and parietal cortex. Consistent with this, enhanced interactions between parietal, frontal and posterior visual cortex are observed as a function of both visual attention and visual awareness; and lesions of parietal cortex disrupt both visual attention and awareness. Taken together, these data suggest that distributed interactions between modality-specific posterior visual cortex and frontoparietal areas subserve both visual attention and visual awareness.
We scanned 18 patients with schizophrenia who had never received neuroleptic medication and 20 age- and sex-matched controls by positron emission tomography with 18-F-fluorodeoxyglucose (fludeoxyglucose F 18) as a tracer of glucose metabolism. Subjects performed the Continuous Performance Test during 18-F-fluorodeoxyglucose uptake. Scan results were converted to metabolic rates, and computer algorithms were used to identify cortical regions. Previous reports of relative hypofrontality in schizophrenia were confirmed, indicating that this finding is not an artifact of previous treatment. Significantly reduced ratios of inferior and medial frontal regions to occipital cortex were found, together with diminished metabolism in the basal ganglia. This suggests the presence of a combined frontostriatal dysfunction in schizophrenia.
: The concept of attention as central to human performance extends back to the start of experimental psychology, yet even a few years ago, it would not have been possible to outline in even a preliminary form a functional anatomy of the human attentional system. New developments in neuroscience have opened the study of higher cognition to physiological analysis, and have revealed a system of anatomical areas that appear to be basic to the selection of information for focal (conscious) processing. The importance of attention is its unique role in connecting the mental level of description of processes used in cognitive science with the anatomical level common in neuroscience. Sperry describes the central role that mental concepts play in understanding brain function. As is the case for sensory and motor systems of the brain, our knowledge of the anatomy of attention is incomplete. Nevertheless, we can now begin to identify some principles of organization that allow attention to function as a unified system for the control of mental processing. Although many of our points are still speculative and controversial, we believe they constitute a basis for more detailed studies of attention from a cognitive-neuroscience viewpoint. Perhaps even more important for furthering future studies, multiple methods of mental chronometry, brain lesions, electrophysiology, and several types of neuro-imaging have converged on common findings.
Local cerebral uptake of glucose labelled with fluorine-18 was measured by positron emission tomography in 13 patients with schizophrenia and 37 right-handed volunteers. Patients received no medication for a minimum of 31 days and a mean of 30 weeks. The subjects were administered the labelled deoxyglucose just after the beginning of a 32-minute sequence of blurred numbers as visual stimuli for the Continuous Performance Test. In normal controls, task performance was associated with increases in glucose metabolic rate in the right frontal and right temporoparietal regions; occipital rates were unchanged. Patients with schizophrenia showed both absolutely and relatively reduced metabolic rates in the frontal cortex and in the temporoparietal regions compared with normal controls.
Two important objectives in the neuroscience of memory are (1) identification of neural pathways involved in memory processes; and (2) characterization of the pattern of interactions between these pathways. Functional neuroimaging can contribute to both of these goals. Using image subtraction analysis of regional cerebral blood flow data measured with positron emission tomography, we identified brain regions that changed activity during episodic memory retrieval (visual work recognition). Relative to a baseline reading task, decreased activity was observed in bilateral prefrontal, bilateral anterior and posterior temporal, and posterior cingulate cortices. Brain regions showing increased activity were the right prefrontal (different from deactivated regions), left anterior cingulate, and left occipital cortices, and vermis of cerebellum. We then performed a network analysis with structural equation modeling to test the hypothesis that regional decreases came about through active inhibition by regions showing increased activity during retrieval. This analysis demonstrated that the influence of activated regions on deactivated regions was more negative during retrieval than during reading, confirming the inhibition hypothesis. Such confirmation could not have been made from the subtraction analysis alone because decreases can come about, at the very least, through reduction of functional influences as well as by active inhibition. The concepts of ensemble excitation and inhibition, as defined through network analysis, are introduced. We argue that is is critical to examine the combined pattern of excitatory and inhibitory influences to fully appreciate the neural basis of episodic memory.
The comparison of the effects of 2 classes of neuroleptic drugs on regional brain functional activities may reveal common mechanisms of antipsychotic drug efficacy.
The regional cerebral glucose metabolic rates of patients with schizophrenia who were and were not receiving neuroleptic drugs and normal control subjects were obtained by positron emission tomography using fludeoxyglucose F 18 as the tracer.
Compared with normal controls and patients not receiving medication, fluphenazine hydrochloride- and clozapine-treated patients had lower global gray matter absolute metabolic rates throughout the cortex. When normalized regional glucose metabolic rates were examined, both medications lowered rates in the superior prefrontal cortex and increased rates in the limbic cortex. Fluphenazine, but not clozapine, increased metabolic rates in the subcortical and lateral temporal lobes, whereas clozapine, but not fluphenazine, decreased inferior prefrontal cortex activity.
These changes are consistent with the idea that neuroleptic drugs lead to "compensation" and "adaptation" rather than "normalization" of the functional activities of brain structures in schizophrenia. The overall similarity of their global and regional metabolic effects suggests that both classes of antipsychotic drugs share some common mechanisms of action. One possibility is that of inducing a shift in the balance of cortical to limbic cortex activity. Differential effects in the inferior prefrontal cortex and the basal ganglia might underlie differences in the therapeutic efficacy and side effect profile of clozapine and fluphenazine.
Few magnetic resonance imaging studies of schizophrenia have investigated brain tissue volumes and their relation to clinical symptoms in patients with an early age at illness onset. The twofold purpose of the study was to investigate both gray and white matter volumes in schizophrenic men with an early age at illness onset, and to determine whether clinical features correlated with tissue volume changes, using an automated voxel-by-voxel image analysis procedure. Twenty male patients with DSM-IV diagnoses of schizophrenia, and an early age at onset (m+/-SD=19+/-2) were compared with 20 age-matched health men. Magnetic resonance (1.5-T) scans were obtained with an Inversion-Recovery prepared fast gradient echo sequence enhancing gray and white matter contrast. Statistical Parametric Mapping was used for image segmentation and comparison. Patients had significant gray matter reductions in medial frontal gyri, left insula, left parahippocampus, and left fusiform gyrus; bilateral white matter reductions in frontal lobes, and increased total cerebrospinal fluid volume were also observed. Negative symptom scores were negatively related to white matter volumes in cingulate regions, and in the right internal capsule. These findings emphasize a pattern of left-hemisphere gray matter abnormalities, and suggest that fronto-paralimbic connectivity may be altered in men with early onset schizophrenia.
The ability to generalize behaviour-guiding principles and concepts from experience is key to intelligent, goal-directed behaviour. It allows us to deal efficiently with a complex world and to adapt readily to novel situations. We review evidence that the prefrontal cortex-the cortical area that reaches its greatest elaboration in primates-plays a central part in acquiring and representing this information. The prefrontal cortex receives highly processed information from all major forebrain systems, and neurophysiological studies suggest that it synthesizes this into representations of learned task contingencies, concepts and task rules. In short, the prefrontal cortex seems to underlie our internal representations of the 'rules of the game'. This may provide the necessary foundation for the complex behaviour of primates, in whom this structure is most elaborate.
Perspective-taking is a complex cognitive process involved in social cognition. This positron emission tomography (PET) study investigated by means of a factorial design the interaction between the emotional and the perspective factors. Participants were asked to adopt either their own (first person) perspective or the (third person) perspective of their mothers in response to situations involving social emotions or to neutral situations. The main effect of third-person versus first-person perspective resulted in hemodynamic increase in the medial part of the superior frontal gyrus, the left superior temporal sulcus, the left temporal pole, the posterior cingulate gyrus, and the right inferior parietal lobe. A cluster in the postcentral gyrus was detected in the reverse comparison. The amygdala was selectively activated when subjects were processing social emotions, both related to self and other. Interaction effects were identified in the left temporal pole and in the right postcentral gyrus. These results support our prediction that the frontopolar, the somatosensory cortex, and the right inferior parietal lobe are crucial in the process of self/other distinction. In addition, this study provides important building blocks in our understanding of social emotion processing and human empathy.
A fundamental issue in neuroscience is the relation between structure and function. However, gross landmarks do not correspond well to microstructural borders and cytoarchitecture cannot be visualized in a living brain used for functional studies. Here, we used diffusion-weighted and functional MRI to test structure-function relations directly. Distinct neocortical regions were defined as volumes having similar connectivity profiles and borders identified where connectivity changed. Without using prior information, we found an abrupt profile change where the border between supplementary motor area (SMA) and pre-SMA is expected. Consistent with this anatomical assignment, putative SMA and pre-SMA connected to motor and prefrontal regions, respectively. Excellent spatial correlations were found between volumes defined by using connectivity alone and volumes activated during tasks designed to involve SMA or pre-SMA selectively. This finding demonstrates a strong relationship between structure and function in medial frontal cortex and offers a strategy for testing such correspondences elsewhere in the brain.
Schizophrenia is a highly heritable psychotic disorder. It has been suggested that deficits of the established state arise from abnormal interactions between brain regions. We sought to examine whether such connectivity abnormalities would be present in subjects at high genetic risk for the disorder. Functional connectivity analysis was carried out on functional MRI images from 21 controls and 69 high risk subjects performing the Hayling sentence completion task; 27 high risk subjects reported isolated psychotic symptoms, the remaining high risk subjects and controls did not. There were no significant differences in task performance between the groups. Based on previous findings we hypothesized: (i) state-related differences in connectivity between dorsolateral prefrontal cortex and lateral temporal lobe; (ii) genetically mediated reductions in a medial prefrontal-thalamic-cerebellar network; and (iii) increased prefrontal-parietal connectivity in high risk subjects (to a greater extent in those with isolated psychotic symptoms). Connectivity analysis was performed in two ways: with and without variance associated with task effects modelled and removed from the data. We did not find evidence to support our first hypothesis with either analysis method. However, consistent with hypothesis (ii), decreased connectivity between right medial prefrontal regions and contralateral cerebellum was found. This was only statistically significant in the analysis with task effects modelled and removed from the data. Finally, consistent with hypothesis (iii), increased connectivity between the left parietal and left prefrontal regions in high risk subjects was found in both analyses. These results, all in a situation uncontaminated by the effects of anti-psychotic medication, performance differences and prolonged illness, suggest there are abnormalities in functional connectivity over and above those attributable to task effects in high risk subjects. These connectivity abnormalities may underlie the diverse deficits seen in the established condition and the more subtle deficits seen in close relatives of those with the disorder.
During performance of attention-demanding cognitive tasks, certain regions of the brain routinely increase activity, whereas others routinely decrease activity. In this study, we investigate the extent to which this task-related dichotomy is represented intrinsically in the resting human brain through examination of spontaneous fluctuations in the functional MRI blood oxygen level-dependent signal. We identify two diametrically opposed, widely distributed brain networks on the basis of both spontaneous correlations within each network and anticorrelations between networks. One network consists of regions routinely exhibiting task-related activations and the other of regions routinely exhibiting task-related deactivations. This intrinsic organization, featuring the presence of anticorrelated networks in the absence of overt task performance, provides a critical context in which to understand brain function. We suggest that both task-driven neuronal responses and behavior are reflections of this dynamic, ongoing, functional organization of the brain.
• functional MRI
• functional connectivity
• spontaneous activity
The morphology of the human cortex varies remarkably across individuals, regardless of overall brain size. It is currently unclear whether related cortical regions covary in gray matter density, as a result of mutually trophic influences or common experience-related plasticity. We acquired a structural magnetic resonance imaging scan from 172 subjects and extracted the regional gray matter densities from 12 readily identifiable regions of interest involved in sensorimotor or higher-order cognitive functions. We then used these values to predict regional densities in the remaining areas of the cortex, using voxel-based morphometry. This revealed patterns of positive and negative covariance that provide insight into the topographical organization of multiple cortical regions. We report that the gray matter density of a region is a good predictor of the density of the homotopic region in the contralateral hemisphere, with the striking exception of primary visual cortex. Whereas some regions express patterns of regional covariance that are mirror symmetrical relative to the interhemispheric fissure, other regions express asymmetric patterns of regional covariance. Finally, patterns of covariance are remarkably consistent between males and females, with the exception of the left amygdala, which is positively associated with the left and right anterior inferior temporal cortex in males and with the right angular gyrus in females. Our study establishes that the density of different cortical regions is coordinated within an individual. The coordinated variations we report are likely to be determined by both genetic and environmental factors and may be the basis for differences in individual behavior.
It is not known whether there is a core abnormality that occurs in all cases of schizophrenia. The cognitive dysmetria hypothesis proposes that there is such an abnormality which is characterized cognitively by a disruption in control and coordination processes, and functionally by abnormal inter-regional connectivity within the cortico-cerebellar-thalamo-cortical circuit (CCTCC). In the current study, we used functional MRI (fMRI) to investigate these two key aspects of the hypothesis. Since patients with schizophrenia show deficits in attention which have been characterized extensively using the continuous performance task (CPT) and since functional imaging studies have also demonstrated that this task engages the CCTCC, we used this task to investigate whether two patient groups with distinct symptom profiles would show functional dysconnectivity within this network. Three groups of subjects participated in the study: healthy volunteers (n = 12), schizophrenia patients with both negative and positive symptoms (n = 11) and schizophrenia patients with primarily positive symptoms (n = 11). Patient groups were matched for age of illness onset and medication, and to the control group for age, gender and handedness. Subjects were scanned using fMRI whilst they performed a modified version of the CPT, involving both degraded and non-degraded stimuli. Stimulus degradation has been shown to produce decrements in sensitivity, which is thought to reflect increased demands on the limited capacity of visual attention. Between-group comparisons revealed that patients with schizophrenia, irrespective of symptomatology, showed attenuation of the anterior cingulate and cerebellar response to stimulus degradation in comparison with control subjects. We also observed disruptions of inter-regional brain integration in schizophrenia. A task-specific relationship between the medial superior frontal gyrus and both anterior cingulate and the cerebellum was disrupted in both patient groups in comparison with controls. In addition, patients with negative symptoms showed impaired behavioural performance, and abnormal task-related connectivity between anterior cingulate and supplementary motor area. These findings are consistent with theoretical accounts of schizophrenia as a disorder of functional integration, and with the cognitive dysmetria hypothesis, which posits a disconnection within the CCTCC as a fundamental abnormality in schizophrenia, independent of diagnostic subtype. Furthermore, these data show evidence of additional functional deficits in patients with negative symptoms, deficits which may explain the accompanying attentional impairment.
According to the distinctiveness heuristic, subjects rely more on detailed recollections (and less on familiarity) when memory is tested for pictures relative to words, leading to reduced false recognition. If so, then neural regions that have been implicated in effortful postretrieval monitoring (e.g., dorsolateral prefrontal cortex) might be recruited less heavily when trying to remember pictures. We tested this prediction with the criterial recollection task. Subjects studied black words, paired with either the same word in red font or a corresponding colored picture. Red words were repeated at study to equate recognition hits for red words and pictures. During fMRI scanning, alternating red word memory tests and picture memory tests were given, using only white words as test stimuli (say "yes" only if you recollect a corresponding red word or picture, respectively). These tests were designed so that subjects had to rely on memory for the criterial information. Replicating prior behavioral work, we found enhanced rejection of lures on the picture test compared to the red word test, indicating that subjects had used a distinctiveness heuristic. Critically, dorsolateral prefrontal activity was reduced when rejecting familiar lures on the picture test, relative to the red word test. These findings indicate that reducing false recognition via the distinctiveness heuristic is not heavily dependent on frontally mediated postretrieval monitoring processes.
this article has been on areas of relative decrease, but we also note that, although less troublesome, the same ambiguity in interpretation of regional decreases also holds for regional increases. Activations can arise from either stronger influences on a region or stronger influence of a region. Moreover, the interpretation of the label "activated" or "deactivated" depends greatly on the reference task. Structural equation modeling can aid in distinguishing the several potential sources of changes in rCBF by examining interactions within a task and then allowing comparison of the interactions between tasks (Fig. 4)
The Continuous Performance Test (CPT) has become an essential constituent of the neuropsychological investigation of schizophrenia. Also, a vast number of brain imaging studies, mostly PET investigations, have employed the CPT as a cognitive challenge and established a relative hypofrontality in schizophrenics compared to controls. The aim of the present investigation was to clarify whether this predescribed hypofrontality could also be verified using functional magnetic resonance imaging (fMRI). 20 healthy volunteers and 14 schizophrenics on stable neuroleptic medication were included. Imaging was performed using the CPT-double-T-version and a clinical 1.5 T MRI-scanner with a single slice technique and a T 2 *-weighted gradient-echo-sequence. The schizophrenics exhibited a decreased activation in the right mesial prefrontal cortex, the right cingulate and the left thalamus compared to controls. These results obtained by fMRI are discussed in relation to published findings using PET.
• We scanned 18 patients with schizophrenia who had never received neuroleptic medication and 20 age- and sex-matched controls by positron emission tomography with 18-F-fluorodeoxyglucose (fludeoxyglucose F 18) as a tracer of glucose metabolism. Subjects performed the Continuous Performance Test during 18-F-fluorodeoxyglucose uptake. Scan results were converted to metabolic rates, and computer algorithms were used to identify cortical regions. Pervious reports of relative hypofrontality in schizophrenia were confirmed, indicating that this finding is not an artifact of previous treatment. Significantly reduced ratios of inferior and medial frontal regions to occipital cortex were found, together with diminished metabolism in the basal ganglia. This suggests the presence of a combined frontostriatal dysfunction in schizophrenia.
Attention is a complex process whose disturbance is considered a core deficit in a number of disorders [e.g., Attention Deficit Hyperactivity Disorder (ADHD), schizophrenia]. In 1956, Rosvold and colleagues [J. Consult. Psychol. 20 (1956) 343.] demonstrated that the continuous performance test (CPT) as a measure of sustained attention was highly sensitive to brain damage or dysfunction. These findings have been replicated with various populations and with various versions of the CPT. The CPT is now cited as the most frequently used measure of attention in both practice and research. Across studies, results are consistent with models of sustained attention that involve the interaction of cortical (frontal, temporal, parietal), subcortical (limbic, basal ganglia), and functional systems including the pathways between the basal ganglia, thalamus, and frontal lobes. Right hemisphere involvement (asymmetric response) is also evident across multiple studies. As such, the CPT demonstrates sensitivity to dysfunction of the attentional system whether this is due to diffuse or more focal damage/dysfunction or in conjunction with any specific disorder. CPT performance can be viewed as symptom specific (attentional disturbance), but it is not disorder specific (e.g., ADHD). Implications for neuropsychological interpretation of CPT results are presented.
Background:
The comparison of the effects of 2 classes of neuroleptic drugs on regional brain functional activities may reveal common mechanisms of antipsychotic drug efficacy.
Methods:
The regional cerebral glucose metabolic rates of patients with schizophrenia who were and were not receiving neuroleptic drugs and normal control subjects were obtained by positron emission tomography using fludeoxyglucose F 18 as the tracer.
Results:
Compared with normal controls and patients not receiving medication, fluphenazine hydrochloride—and clozapine-treated patients had lower global gray matter absolute metabolic rates throughout the cortex. When normalized regional glucose metabolic rates were examined, both medications lowered rates in the superior prefrontal cortex and increased rates in the limbic cortex. Fluphenazine, but not clozapine, increased metabolic rates in the subcortical and lateral temporal lobes, whereas clozapine, but not fluphenazine, decreased inferior prefrontal cortex activity.
Conclusions:
These changes are consistent with the idea that neuroleptic drugs lead to "compensation" and "adaptation" rather than "normalization" of the functional activities of brain structures in schizophrenia. The overall similarity of their global and regional metabolic effects suggests that both classes of antipsychotic drugs share some common mechanisms of action. One possibility is that of inducing a shift in the balance of cortical to limbic cortex activity. Differential effects in the inferior prefrontal cortex and the basal ganglia might underlie differences in the therapeutic efficacy and side effect profile of clozapine and fluphenazine.
Statistical parametric maps are spatially extended statistical processes that are used to test hypotheses about regionally specific effects in neuroimaging data. The most established sorts of statistical parametric maps (e.g., Friston et al. [1991]: J Cereb Blood Flow Metab 11:690–699; Worsley et al. [1992]: J Cereb Blood Flow Metab 12:900–918) are based on linear models, for example ANCOVA, correlation coefficients and t tests. In the sense that these examples are all special cases of the general linear model it should be possible to implement them (and many others) within a unified framework. We present here a general approach that accomodates most forms of experimental layout and ensuing analysis (designed experiments with fixed effects for factors, covariates and interaction of factors). This approach brings together two well established bodies of theory (the general linear model and the theory of Gaussian fields) to provide a complete and simple framework for the analysis of imaging data.
The importance of this framework is twofold: (i) Conceptual and mathematical simplicity, in that the same small number of operational equations is used irrespective of the complexity of the experiment or nature of the statistical model and (ii) the generality of the framework provides for great latitude in experimental design and analysis.
An algorithm for reducing the envelope of a sparse matrix is presented. This algorithm is based on the computation of eigenvectors of the Laplacian matrix associated with the graph of the sparse matrix. A reordering of the sparse matrix is determined based on the numerical values of the entries of an eigenvector of the Laplacian matrix. Numerical results show that the new reordering algorithm can in some cases reduce the envelope by more than a factor of two over the current standard algorithms such as Gibbs-Poole-Stockmeyer or SPARSPAK's reverse Cuthill-McKee.
The problem of reordering a sparse symmetric matrix to reduce its envelope size is considered. A new spectral algorithm for computing an envelope-reducing reordering is obtained by associating a Laplacian matrix with the given matrix and then sorting the components of a specified eigenvector of the Laplacian. This Laplacian eigenvector solves a continuous relaxation of a discrete problem related to envelope minimization called the minimum 2-sum problem. The permutation vector computed by the spectral algorithm is a closest permutation vector to the specified Laplacian eigenvector. Numerical results show that the new reordering algorithm usually computes smaller envelope sizes than those obtained from the current standard algorithms such as Gibbs-Poole-Stockmeyer (GPS) or SPARSPAK reverse Cuthill-McKee (RCM), in some cases reducing the envelope by more than a factor of two.
To assess cognitively-related regional asymmetries of brain function, regional cerebral blood flow (rCBF) was determined by the xenon inhalation method while normal subjects performed 10 different tasks and also while they were at rest. In addition to healthy subjects, patients with schizophrenia were also studied. A total of 447 rCBF studies were carried out during the following conditions: the Wisconsin Card Sort Test, a numbers matching test, a symbols matching test, Raven's Progressive Matrices, an auditory discrimination test, an auditory control task, two versions of a visual continuous performance task, line orientation, semantic classification, and resting. On the whole, those tasks that seem to require or allow for internal verbalisation resulted in the greatest activation of the left hemisphere compared with the right; right hemisphere activation predominated only in the two tasks primarily involving attention and vigilance. Furthermore, a consistent regional topography of normal cerebral functional laterality was seen: under most conditions left prefrontal cortical activity exceeded that of right prefrontal cortex; during all non-auditory tasks, parieto-occipital cortical activity had an opposite pattern-greater right than left. During most conditions the schizophrenic patients displayed the same pattern. While several cognitively specific between-group differences were found, no single cortical region was consistently implicated and no specific direction of abnormal asymmetry predominated. These data suggest that there is a predominant task-independent functional pattern of cortical activity emphasising relatively greater left anterior and right posterior activation. This pattern may reflect the verbal and attentional primacy of these areas, respectively.
Synopsis
Eighty-three patients with schizophrenia and 47 healthy controls received positron emission tomography (PET) with 18F-2-deoxyglucose uptake while they were executing the Continuous Performance Test (CPT). The entire cortex was divided into 16 regions of interest in each hemisphere, four in each lobe of the brain, and data from corresponding right and left hemispheric regions were averaged. Data from the schizophrenic patients were subjected to a factor analysis, which revealed five factors that explained 80% of the common variance. According to their content, the factors were identified and labelled ‘parietal cortex and motor strip’, ‘associative areas’, ‘temporal cortex’, ‘hypofrontality’ (which included midfrontal and occipital areas) and ‘frontal cortex’. Hemispheric asymmetry was only confirmed for the temporal cortex. Factor weights obtained in the schizophrenic group were applied to the metabolic data of the healthy controls and factor scales computed. Schizophrenics were significantly more hypofrontal than the controls, with higher values on the ‘parietal cortex and motor strip’ factor and a trend towards higher values in the temporal cortex. A canonical discriminant analysis confirmed that the ‘hypofrontality’ and ‘parietal cortex and motor strip’ factors accurately separated the schizophrenic group from the healthy controls. Hemispheric asymmetry was only confirmed for the temporal lobe. Significantly higher factor scores for the left temporal lobe in schizophrenics than in normals were obtained when calculated for the right and left hemisphere separately. Taken together, our results confirm the importance of hypofrontality as a pattern of cortical metabolic rate and point to the potential importance of parietal and motor strip function in schizophrenia.
The cortical-striatal-thalamic circuit modulates cognitive processing and thus may be involved in the cognitive dysfunction in schizophrenia. The imaging of metabolic rate in the structures making up this circuit could reveal the correlates of schizophrenia and its main symptoms.
Seventy male schizophrenic patients underwent [18F]-fluorodeoxyglucose positron emission tomography after a period of at least 4 weeks during which they had not received neuroleptic medication and were compared to 30 age-matched male normal comparison subjects.
Analyses revealed decreased metabolism in medial frontal cortex, cingulate gyrus, medial temporal lobe, corpus callosum, and ventral caudate and increased metabolism in the left lateral temporal and occipital cortices in the schizophrenic cohort. Consistent with previous studies, the schizophrenic group had lower hypofrontality scores (ratios of lateral frontal to occipital metabolism) than did comparison subjects. The lateral frontal cortical metabolism of schizophrenic patients did not differ from that of comparison subjects, while occipital cortical metabolism was high, suggesting that lateral hypofrontality is due to abnormalities in occipital rather than lateral frontal activity. Hypofrontality was more prominent in medial than lateral frontal cortex. Brief Psychiatric Rating Scale (BPRS) scores, obtained for each schizophrenic patient on the scan day, were correlated with regional brain glucose metabolic rate. Medial frontal cortical and thalamic activity correlated negatively with total BPRS score and with positive and negative symptom scores. Lateral frontal cortical metabolism and hypofrontality scores did not significantly correlate with negative symptoms. Analyses of variance demonstrated a reduced right greater than left asymmetry in the schizophrenic patients for the lateral cortex as a whole, with simple interactions showing this effect specifically in temporal and frontal cortical regions.
Low metabolic rates were confirmed in medial frontal cortical regions as well as in the basal ganglia, consistent with the importance of the cortical-striatal-thalamic pathways in schizophrenia. Loss of normal lateralization patterns was also observed on an exploratory basis. Correlations with negative symptoms and group differences were more prominent in medial than lateral frontal cortex, suggesting that medial regions may be more important in schizophrenic pathology.
We studied 18 never-mediated schizophrenic patients and 22 normal control subjects with 18F-deoxyglucose (FDG) positron emission tomography. Patients and controls performed the continuous performance test during FDG uptake. Cortical and subcortical structures comprising two circuits selected on the basis of several theoretical models of schizophrenia were examined. The correlation of glucose metabolic rate (GMR) for each structure in each circuit with connected structures was calculated and tested for two-tailed significance. Schizophrenics showed significantly different patterns of intercorrelations for both circuits. The largest difference was in the correlation of GMR in the anterior thalamus with the frontal cortex, a key element in the thalamo-cortical-striatal circuit suggested to be abnormal in some models of schizophrenia. Correlations of the frontal lobe with other regions were also more positive in normal controls than schizophrenics; controls had three correlational paths from the frontal cortex (to temporal cortex, ventral anterior thalamus, and dorsal medial thalamus) with significantly more positive correlations than schizophrenics perhaps consistent with other findings of frontal cortical dysfunction in schizophrenia. Normal controls also had both more significant positive and more significant negative correlations between the occipital cortex and other brain areas than schizophrenics. Correlations between homologous areas in the right and left hemispheres were prominent in both groups.
Attentional modulation of cortical activity was examined by varying the rate of visual stimuli in object categorization tasks according to single and conjoined features. Activation of dorsolateral frontal cortex was independent of the stimulus presentation rate and elicited by the participant's attention to conjoined compared with single features. Several cortical regions showed attentionally modulated activity. In inferior temporal cortex, modulation was due to an additional bias signal underlying normal rate-correlated activity. In two other regions (premotor cortex and cerebellum), attention modified the correlation of activity and the stimulus presentation rate. Attentional effects in the human cortex are expressed by at least two physiologically distinct mechanisms acting on spatially distributed areas.
This paper presents a new method for characterizing brain responses in both PET and fMRI data. The aim is to capture the correlations between the scans of an experiment and a set of external predictor variables that are thought to affect the scans, such as type, intensity, or shape of stimulus response. Its main feature is a Canonical Variates Analysis (CVA) of the estimated effects of the predictors from a multivariate linear model (MLM). The advantage of this over current methods is that temporal correlations can be incorporated into the model, making the MLM method suitable for fMRI as well as PET data. Moreover, tests for the presence of any correlation, and inference about the number of canonical variates needed to capture that correlation, can be based on standard multivariate statistics, rather than simulations. When applied to an fMRI data set previously analyzed by another CVA method, the MLM method reveals a pattern of responses that is closer to that detected in an earlier non-CVA analysis.
The Continuous Performance Test (CPT) has become an essential constituent of the neuropsychological investigation of schizophrenia. Also, a vast number of brain imaging studies, mostly PET investigations, have employed the CPT as a cognitive challenge and established a relative hypofrontality in schizophrenics compared to controls. The aim of the present investigation was to clarify whether this predescribed hypofrontality could also be verified using functional magnetic resonance imaging (fMRI). 20 healthy volunteers and 14 schizophrenics on stable neuroleptic medication were included. Imaging was performed using the CPT-double-T-version and a clinical 1.5 T MRI-scanner with a single slice technique and a T(2)*-weighted gradient-echo-sequence. The schizophrenics exhibited a decreased activation in the right mesial prefrontal cortex, the right cingulate and the left thalamus compared to controls. These results obtained by fMRI are discussed in relation to published findings using PET.
Functional brain imaging in humans has revealed task-specific increases in brain activity that are associated with various mental activities. In the same studies, mysterious, task-independent decreases have also frequently been encountered, especially when the tasks of interest have been compared with a passive state, such as simple fixation or eyes closed. These decreases have raised the possibility that there might be a baseline or resting state of brain function involving a specific set of mental operations. We explore this possibility, including the manner in which we might define a baseline and the implications of such a baseline for our understanding of brain function.
Functional studies of auditory spatial attention generally report enhanced neural responses in auditory cortical regions. However, activity in regions of the spatial attentional network as described in the visual modality is not consistently observed. Data analysis limitations due to oppositely lateralized activity depending on the side of attentional orientation and heterogeneity of paradigms makes it hard to untangle the possible causes of these various activation patterns. In the present article we present a PET study of auditory spatial attention in which we manipulated orientation of attention, attentional load, and difficulty of the task by means of the dichotic listening paradigm. Moreover, we designed a systematic, voxel-specific, method in order to deal with oppositely lateralized activity. The results show that when listeners are involved in auditory spatial attention tasks an interacting network of frontal, temporal, and parietal regions is activated. Selective orientation toward one side mostly yields activity and connectivity modulations in the hemisphere contralateral to the attended side while in divided attention activity is mostly bilateral. Taken together, our observations are consistent with the idea of a multimodal large-scale attentional network.
We used a parametric experimental design to identify the rCBF variations related to a continuous variation of the attention load. The experiment involved goal-directed visual tasks. The length of time during which the subject's attention was engaged toward the external stimulus was taken as the factor of interest. The neural network revealed areas that positively (left cerebellum, bilateral MT/V5 complex and superior parietal lobule, right inferior temporal lobe and dorsolateral prefrontal cortex) or negatively (precuneus, anterior cingulate and medial superior frontal cortex) correlate with the attention load. Results demonstrate that the activity of these areas varies continuously as a function of the variation in the attention load.
The clinical hallmark of schizophrenia is psychosis. The objective of this overview is to link the neurobiology (brain), the phenomenological experience (mind), and pharmacological aspects of psychosis-in-schizophrenia into a unitary framework.
Current ideas regarding the neurobiology and phenomenology of psychosis and schizophrenia, the role of dopamine, and the mechanism of action of antipsychotic medication were integrated to develop this framework.
A central role of dopamine is to mediate the "salience" of environmental events and internal representations. It is proposed that a dysregulated, hyperdopaminergic state, at a "brain" level of description and analysis, leads to an aberrant assignment of salience to the elements of one's experience, at a "mind" level. Delusions are a cognitive effort by the patient to make sense of these aberrantly salient experiences, whereas hallucinations reflect a direct experience of the aberrant salience of internal representations. Antipsychotics "dampen the salience" of these abnormal experiences and by doing so permit the resolution of symptoms. The antipsychotics do not erase the symptoms but provide the platform for a process of psychological resolution. However, if antipsychotic treatment is stopped, the dysregulated neurochemistry returns, the dormant ideas and experiences become reinvested with aberrant salience, and a relapse occurs.
The article provides a heuristic framework for linking the psychological and biological in psychosis. Predictions of this hypothesis, particularly regarding the possibility of synergy between psychological and pharmacological therapies, are presented. The author describes how the hypothesis is complementary to other ideas about psychosis and also discusses its limitations.
Schizophrenic patients show deficits in working memory (WM) and inhibition of prepotent responses. We examined brain activity while subjects performed tasks that placed demands on WM and overriding prepotent response tendencies, testing predictions that both processes engage overlapping prefrontal cortical (PFC) regions and that schizophrenic patients show reduced PFC activity and performance deficits reflecting both processes.
Functional magnetic resonance imaging data were acquired while 16 schizophrenic and 15 healthy subjects performed the N-Back task that varied WM load and a version of the AX-CPT that required overriding a prepotent response tendency.
Both tasks engaged overlapping cortical networks (e.g., bilateral dorsolateral PFC, Broca's area, parietal cortex). Increased WM load monotonically increased activity; preparation to override a prepotent response produced greater and more enduring activity. Group differences on each task emerged in a right dorsolateral PFC region: schizophrenic subjects showed lesser magnitude increases under conditions of high WM and prepotent response override demands, with concomitant performance impairments.
Schizophrenic patients exhibit PFC-mediated deficits in WM and preparation to override prepotent responses. Findings are consistent with the operation of a single underlying PFC-mediated cognitive control mechanism and with physiologic dysfunction of the dorsolateral PFC in schizophrenic patients reflecting impairments in this mechanism.
Structural equation modelling was used to study the change of connectivity during a visual task with continuous variation of the attention load. The model was based on areas defined by the haemodynamic responses described elsewhere [Mazoyer, P., Wicker, B. & Fonlupt, P. (2002) A neural network elicited by parametric manipulation of the attention load. Neuroreport, 13, 2331-2334], including occipitotemporal, parietal, temporal and prefrontal (lateral and medial areas) cortices. We have studied stationary- (which does not depend on the attentional load) and attention-related coupling between areas. This allowed the segregation of two subsystems. The first could reflect a system performing the integration step of the visual signal and the second a system participating in response selection. The major finding is the mutual negative influence between the lateral and medial parts of the prefrontal cortex. This negative influence between these two brain regions increased with the attention load. This is interpreted as a modification of the balance between integration and decision processes that are needed for the task to be efficiently completed.
Neuroimaging techniques such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are widely used to identify the cerebral correlates of cognitive tasks. The resting state presents the advantage to serve as a reference in all experiments but is also an ill-defined mental state because it may vary both from one subject to another and within the same subject. The most challenging question concerns the areas whose activity (revealed by PET or fMRI imaging) is greater in rest state than in an active condition. The present work reports the result of a meta-analysis including five previously published studies. The five different tasks involved are the following: attribution of intention, judgement of stimulus pleasantness, discrimination of spatial attributes, judgement of other peoples' belief and perception of gaze. For each study, the general linear model was used to assess statistical difference and a contrast resting state minus other conditions was calculated. The intersection of the five contrasts was used to search for the variation jointly observed across the different experiments. This lead to a reduced number of clusters: one cluster in the lower/anterior part of the cingulate gyrus and four clusters located in the medial/superior frontal gyrus, along the superior frontal sulcus. We discuss the location of these areas with respect to the location of activations induced by different tasks: externally focused attention, memory, general reasoning, theory of mind and self-referential tasks. We observed that medial prefrontal cortex exhibits a lower activity when the subject's attention is focused towards the external world than when the subject has to additionally refer to some internal states. By contrast, this activity is greater during resting state than during both externally directed and internally directed attention. Thus, we hypothesize that during rest, the subject is in a state where he refers only to his own self.
Attention is a complex process whose disturbance is considered a core deficit in a number of disorders [e.g., Attention Deficit
Hyperactivity Disorder (ADHD), schizophrenia]. In 1956, Rosvold and colleagues [J. Consult. Psychol. 20 (1956) 343.] demonstrated
that the continuous performance test (CPT) as a measure of sustained attention was highly sensitive to brain damage or dysfunction.
These findings have been replicated with various populations and with various versions of the CPT. The CPT is now cited as
the most frequently used measure of attention in both practice and research. Across studies, results are consistent with models
of sustained attention that involve the interaction of cortical (frontal, temporal, parietal), subcortical (limbic, basal
ganglia), and functional systems including the pathways between the basal ganglia, thalamus, and frontal lobes. Right hemisphere
involvement (asymmetric response) is also evident across multiple studies. As such, the CPT demonstrates sensitivity to dysfunction
of the attentional system whether this is due to diffuse or more focal damage/dysfunction or in conjunction with any specific
disorder. CPT performance can be viewed as symptom specific (attentional disturbance), but it is not disorder specific (e.g.,
ADHD). Implications for neuropsychological interpretation of CPT results are presented.
Physiological studies of auditory perception have not yet clearly distinguished sensory from decision processes. In this experiment, human participants identified speech sounds masked by varying levels of noise while blood oxygenation signals in the brain were recorded with functional magnetic resonance imaging (fMRI). Accuracy and response time were used to characterize the behavior of sensory and decision components of this perceptual system. Oxygenation signals in a cortical subregion just anterior and lateral to primary auditory cortex predicted accuracy of sound identification, whereas signals in an inferior frontal region predicted response time. Our findings provide neurophysiological evidence for a functional distinction between sensory and decision mechanisms underlying auditory object identification. The present results also indicate a link between inferior frontal lobe activation and response-selection processes during auditory perception tasks.
Activations in human dorsomedial frontal and cingulate cortices are often present in neuroimaging studies of decision making and action selection. Interpretations have emphasized executive control, movement sequencing, error detection and conflict monitoring. Recently, however, experimental approaches, using lesions, inactivation, and cell recording, have suggested that these are just components of the areas' functions. Here we review these results and integrate them with those from neuroimaging. A medial superior frontal gyrus (SFG) region centred on the pre-supplementary motor area (pre-SMA) is involved in the selection of action sets whereas the anterior cingulate cortex (ACC) has a fundamental role in relating actions to their consequences, both positive reinforcement outcomes and errors, and in guiding decisions about which actions are worth making.
Novelty seeking is a temperament trait characterized by impulsiveness and exploratory behavior. Dopamine has been suggested to be the primary neurotransmitter modulator of novelty seeking, and in young healthy subjects, a correlation between increased novelty seeking and decreased insular cortical dopamine D2 receptor availability has been reported. The proposed link between dopamine deficiency and reduction in novelty seeking in Parkinson's disease is controversial. The present study examined whether a link between insular D2 receptor availability and novelty seeking can be replicated in Parkinson's disease patients. [11C]FLB 457 positron emission tomography imaging was carried out in 28 patients with Parkinson's disease, and the data were analyzed using voxel-based statistical analysis. The results demonstrated a negative correlation between the novelty seeking score and the dopamine D2 availability bilaterally in the insular cortex (corrected P=0.001; r=-0.74 [right hemisphere]; r=-0.66 [left hemisphere]). The results provide further support for a relationship between novelty seeking and insular D2 receptors. They indicate that the association is cross-cultural, independent of age, and unaffected by dopaminergic degeneration.
The disconnectivity hypothesis proposes that schizophrenia results from poor or miswired anatomical connections. Theoretically, its functional counterpart should be disintegration. Integration is thought to allow segregated neurons to interact as a coherent whole, referred to as the “core”, while the non-interacting part of the brain is referred to as the “rest”. In this study, it is suggested that schizophrenia is the result of rest noise interfering with core activity. Two possible causes are assessed: (i) defective core integration, making the core more vulnerable to noise from the rest, or (ii) the rest being too highly integrated, meaning that it can interfere with the core.
Patients with schizophrenia frequently demonstrate hypofrontality in tasks that require executive processing; however questions still remain as to whether prefrontal cortex dysfunctions are specific to schizophrenia, or a general feature of major psychopathology. Context processing is conceptualized as an executive function associated with attention and working memory processes. Impairment in the ability of patients with schizophrenia to represent and maintain context information has been previously reported in a number of studies. To examine the question of the specificity of a context processing deficit to schizophrenia, we used functional MRI and an expectancy AX continuous performance task designed to assess context processing in a group of healthy controls (n=9), depressed patient controls (n=10), and patients with schizophrenia (n=7). The behavioral performance was consistent with a context processing deficit in patients with schizophrenia, but not those with depression. The imaging data replicate previous results in showing abnormal activity in the right middle frontal gyrus (BA9) in schizophrenia patients related to context processing.
Voxel-based morphometry (VBM) allows the output of structural data in a Statistical Parametric Map of the brain in the same way that the SPM can do with functional data. Using functional magnetic resonance (fMR), we studied brain activation in 14 patients with schizophrenia and 14 matched normal controls. We found significant hypoactivation in patients in several regions, especially in the right hemisphere, in the dorsolateral frontal and temporal regions and in the inferior parietal. Subcortically, we found strong hypoactivity in the thalamus. The optimized VBM method revealed gray matter (GM) abnormalities in the bilateral supramarginal gyrus and cingulate cortex, and in the right inferior temporal regions. Three regions involved in attentional processes showed both structural and functional deficits: the thalamus, the anterior cingulate and the inferior parietal. The results suggest that these regions may be involved in the attentional deficit in schizophrenia.
Functional magnetic resonance imaging (fMRI) time series analysis and statistical inferences about the effect of a cognitive task on the regional cerebral blood flow (rCBF) are largely based on the linear model. However, this method requires that the error vector is a gaussian variable with an identity correlation matrix. When this assumption cannot be accepted, statistical inferences can be made using generalized least squares. In this case, knowledge of the covariance matrix of the error vector is needed. In the present report, we propose a method that needs stationarity of the autocorrelation function but is more flexible than autoregressive model of order p (AR(p)) models because it is not necessary to predefine a relation between coefficients of the correlation matrix. We tested this method on sets of simulated data (with presence of an effect of interest or not) representing a time series with a monotonically decreasing autocorrelation function. This time series mimicked an experiment using a random event-related design that does not create correlation between scans. The autocorrelation function is empirically determined and used to reconstitute the correlation matrix as the toeplitz matrix built from the autocorrelation function. When applied to simulated time series with no effect of interest, this method allows the determination of F values corresponding to the accurate false positive level. Moreover, when applied to time series with an effect of interest, this method gives a density function of F values which allows the rejection of the null hypothesis. This method provides a flexible but interpretable time domain noise model.
The anterior medial prefrontal cortex (aMPFC) is consistently active during personally salient decisions, yet the differential contributory processes of this region along the dorsal-ventral axis are less understood. Using a self-appraisal decision-making task and functional magnetic resonance imaging, we demonstrated task-dependent connectivity of ventral aMPFC with amygdala, insula, and nucleus accumbens, and dorsal aMPFC connectivity with dorsolateral PFC and bilateral hippocampus. These aMPFC networks appear to subserve distinct contributory processes inherent to self-appraisal decisions, specifically a dorsally mediated cognitive and a ventrally mediated affective/self-relevance network.
This study investigates the sets of brain areas that are functionally connected during an auditory goal-directed task. We used a paradigm including a resting state condition and an active condition, which consisted in active listening to the footsteps of walking humans. The regional brain activity was measured using fMRI and the adjusted values of activity in brain regions involved in the task were analysed using both principal component analysis and structural equation modelling. A first set of connected areas includes regions located in Heschl's gyrus, planum temporale, posterior superior temporal sulcus (in the so-called 'social cognition' area), and parietal lobe. This network could be responsible for the perceptual integration of the auditory signal. A second set encompassing frontal regions is related to attentional control. Dorsolateral- and medial-prefrontal cortex have mutual negative influences which are similar to those described during a visual goal-directed task [T. Chaminade & P. Fonlupt (2003) Eur. J. Neurosci., 18, 675-679.]. Moreover, the dorsolateral prefrontal cortex (DLPFC) exerts a positive influence on the auditory areas during the task, as well as a strong negative influence on the visual areas. These results show that: (i) the negative influence between the medial and lateral parts of the frontal cortex during a goal-directed task is not dependent on the input modality (visual or auditory), and (ii) the DLPFC activates the pathway of the relevant sensory modality and inhibits the nonrelevant sensory modality pathway.
Nearly all neuroimaging data analysis rests upon some form of variance partitioning. Conventional analyses, with a general linear model (GLM), partition the variance in the measured response variable into partitions described by a design matrix of explanatory variables. This approach can also be adopted in the initial modeling of the data in studies using data-led methods to summarize functional connectivity, such as principle component analysis, or studies of effective connectivity, using for example structural equation modeling. The point made in this technical note is that the partition of the original time series has to be precisely described to qualify the sources of variations that are taken into account. For conventional analyses using the GLM, the partition investigated corresponds to the subspaces of the design matrix that are tested. However, in the analyses of functional and effective connectivity, the particular subspaces considered are not always specified explicitly. Here we show that selecting different subspaces, or variance partitions, can have a profound effect, both qualitatively and quantitatively, on the sample covariances and the ensuing inferences about connectivity. We will illustrate this using simulated data that include condition and block-related effects and their interactions. We will use these three subspaces to show how the correlation between two voxels depends on which sub-partitions are examined. We will also show how the partition of the design matrix influences the resulting correlation matrix observed when studying correlations between error terms. We will finally demonstrate, quantitatively, the effect of the variance partitions considered on the correlations between two regions using a real fMRI study of biological motion.