Abnormalities in the Distributed Network of Sustained Attention Predict Neuroleptic Treatment Response in Schizophrenia

Cohen, M.D Robert M; Nordahl, M.D Thomas E; Semple, William E.; Andreason, M.D Paul; Pickar, M.D David

doi:10.1016/s0893-133x(97)00201-7

Cited by 40 publications

(6 citation statements)

References 40 publications

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“…These data are in agreement with those of Buchsbaum (Buchsbaum et al 2007; Buchsbaum et al 1992) who found that lower pretreatment and greater increase in striatal metabolic rate with treatment were linked to better clinical response to APDs. Likewise, Cohen (Cohen et al 1998) found that high pretreatment basal ganglia rates predicted poor treatment response to APDs. Treatment resistant subjects who became responders to clozapine showed higher basal ganglia perfusion compared to those who did not (Rodriguez et al 1997).…”

Section: Discussionmentioning

confidence: 99%

Modulation of Limbic Circuitry Predicts Treatment Response to Antipsychotic Medication: A Functional Imaging Study in Schizophrenia

Lahti

Weiler

Holcomb

et al. 2009

Neuropsychopharmacol

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The regional neuronal changes taking place in the early and late stages of antipsychotic treatment are still not well characterized in humans. In addition, it is not known whether these regional changes are predictive or correlated with treatment response. Using PET with 15O, we evaluated the time course of regional cerebral blood flow (rCBF) patterns generated by a first (haloperidol) and a second (olanzapine) generation antipsychotic drug (APD) in patients with schizophrenia during a 6 week treatment trial.Patients were initially scanned after withdrawal of all psychotropic medication (two weeks), and then blindly randomized to treatment with haloperidol (n=12) or olanzapine (n=17) for a period of 6 weeks. Patients were scanned again after 1 and 6 weeks of treatment. All assessments, including scanning sessions, were obtained in a double-blind manner.As hypothesized, we observed rCBF changes that were common to both drugs, implicating cortico-subcortical and limbic neuronal networks in antipsychotic action. In addition, in these regions, some patterns seen at week 1 and 6 were distinctive, indexing neuronal changes related to an early (ventral striatum, hippocampus) and consolidated [anterior cingulate/medial frontal cortex (ACC/MFC)] stage of drug response. Finally, both after 1 and 6 weeks of treatment, we observe differential patterns of rCBF activation between good and poor responders. After one week of treatment, greater rCBF increase in ventral striatum and greater decrease in hippocampus were associated with good response.

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Section: Discussionmentioning

confidence: 99%

Modulation of Limbic Circuitry Predicts Treatment Response to Antipsychotic Medication: A Functional Imaging Study in Schizophrenia

Lahti

Weiler

Holcomb

et al. 2009

Neuropsychopharmacol

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“…However, we note that despite these methodological differences, several studies have also previously reported abnormal function of the anterior cingulate during CPT performance in patients with schizophrenia (Buchsbaum et al ., 1992; Schroder et al ., 1996; Cohen et al ., 1997, 1998 a ; Volz et al ., 1999; Carter et al ., 2001) and in non-psychotic familial relatives (Thermenos et al ., 2004). In addition, Cohen et al . (1998b) found that reduced metabolism in the right anterior midprefrontal cortex predicted a better response to neuroleptics, and reduced cingulate metabolism predicted a poor response.…”

Section: Discussionmentioning

confidence: 99%

Functional dysconnectivity in schizophrenia associated with attentional modulation of motor function

Honey

Pomarol‐Clotet

Corlett

et al. 2005

Brain

187

107

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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.

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“…1. Thirty-six studies (Al-Mousawi et al, 1996;Bartlett et al, 1991;Bertollo, Cowen, & Levy, 1996;Biver et al, 1995;Buchsbaum et al, 1984Buchsbaum et al, , 1990Buchsbaum et al, , 1992Buchsbaum et al, , 1996Clark, Kopala, Hurwitz, & Li, 1991;Clark, Kopala, Li, & Hurwitz, 2001;Cleghorn et al, 1989;Cohen et al, 1997;Cohen, Nordahl, Semple, Andreason, & Pickar, 1998;Cohen, Nordahl, Semple, & Pickar, 1999;DeLisi et al, 1989;Farkas et al, 1984;Fujimoto et al, 2007;Gur et al, 1995bGur et al, , 1987aHazlett et al, 1998Hazlett et al, , 1999Hazlett et al, , 2000Huret et al, 1991;Jacobsen et al, 1997;Lehrer et al, 2005;Mitelman et al, 2020;Molina, Sanz, Sarramea, Benito, & Palomo, 2005;Nordahl et al, 2001Nordahl et al, , 1996Resnick, Gur, Alavi, Gur, & Reivich, 1988;Shihabuddin et al, 1998Shihabuddin et al, , 2001Siegel et al, 1993;Tamminga et al, 1992;Wolkin et al, 1988Wolkin et al, , 1985, reporting results for 642 patients and 693 healthy controls, were included in the quantitative analysis. Study characteristics are reported in Table 1.…”

Section: Study Selectionmentioning

confidence: 99%

Brain glucose metabolism in schizophrenia: a systematic review and meta-analysis of ¹⁸FDG-PET studies in schizophrenia

et al. 2022

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Background Impaired brain metabolism may be central to schizophrenia pathophysiology, but the magnitude and consistency of metabolic dysfunction is unknown. Methods We searched MEDLINE, PsychINFO and EMBASE between 01/01/1980 and 13/05/2021 for studies comparing regional brain glucose metabolism using 18FDG-PET, in schizophrenia/first-episode psychosis v. controls. Effect sizes (Hedges g) were pooled using a random-effects model. Primary measures were regional absolute and relative CMRGlu in frontal, temporal, parietal and occipital lobes, basal ganglia and thalamus. Results Thirty-six studies (1335 subjects) were included. Frontal absolute glucose metabolism (Hedge's g = −0.74 ± 0.54, p = 0.01; I2 = 67%) and metabolism relative to whole brain (g = −0.44 ± 0.34, p = 0.01; I2 = 55%) were lower in schizophrenia v. controls with moderate heterogeneity. Absolute frontal metabolism was lower in chronic (g = −1.18 ± 0.73) v. first-episode patients (g = −0.09 ± 0.88) and controls. Medicated patients showed frontal hypometabolism relative to controls (−1.04 ± 0.26) while metabolism in drug-free patients did not differ significantly from controls. There were no differences in parietal, temporal or occipital lobe or thalamic metabolism in schizophrenia v. controls. Excluding outliers, absolute basal ganglia metabolism was lower in schizophrenia v. controls (−0.25 ± 0.24, p = 0.049; I2 = 5%). Studies identified reporting voxel-based morphometry measures of absolute 18FDG uptake (eight studies) were also analysed using signed differential mapping analysis, finding lower 18FDG uptake in the left anterior cingulate gyrus (Z = −4.143; p = 0.007) and the left inferior orbital frontal gyrus (Z = −4.239; p = 0.02) in schizophrenia. Conclusions We report evidence for hypometabolism with large effect sizes in the frontal cortex in schizophrenia without consistent evidence for alterations in other brain regions. Our findings support the hypothesis of hypofrontality in schizophrenia.

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Abnormalities in the Distributed Network of Sustained Attention Predict Neuroleptic Treatment Response in Schizophrenia

Abstract: The regional cerebral metabolic rates of 19 male medicationwithdrawn schizophrenic patients were determined by positron emission tomography (PET) while performing an auditory discrimination task (CPT)

Cited by 40 publications

References 40 publications

Modulation of Limbic Circuitry Predicts Treatment Response to Antipsychotic Medication: A Functional Imaging Study in Schizophrenia

Modulation of Limbic Circuitry Predicts Treatment Response to Antipsychotic Medication: A Functional Imaging Study in Schizophrenia

Functional dysconnectivity in schizophrenia associated with attentional modulation of motor function

Brain glucose metabolism in schizophrenia: a systematic review and meta-analysis of ¹⁸FDG-PET studies in schizophrenia

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Abnormalities in the Distributed Network of Sustained Attention Predict Neuroleptic Treatment Response in Schizophrenia

Abstract: The regional cerebral metabolic rates of 19 male medicationwithdrawn schizophrenic patients were determined by positron emission tomography (PET) while performing an auditory discrimination task (CPT)

Cited by 40 publications

References 40 publications

Modulation of Limbic Circuitry Predicts Treatment Response to Antipsychotic Medication: A Functional Imaging Study in Schizophrenia

Modulation of Limbic Circuitry Predicts Treatment Response to Antipsychotic Medication: A Functional Imaging Study in Schizophrenia

Functional dysconnectivity in schizophrenia associated with attentional modulation of motor function

Brain glucose metabolism in schizophrenia: a systematic review and meta-analysis of 18FDG-PET studies in schizophrenia

Contact Info

Product

Resources

About

Brain glucose metabolism in schizophrenia: a systematic review and meta-analysis of ¹⁸FDG-PET studies in schizophrenia