Decreased blood flow in the right insula and middle temporal gyrus predicts negative formal thought disorder in schizophrenia

Winkelbeiner, Stephanie; Cavelti, Marialuisa; Federspiel, Andrea; Kunzelmann, Katharina; Dierks, Thomas; Strik, Werner; Horn, Helge; Homan, Philipp

doi:10.1016/j.schres.2018.06.009

Cited by 15 publications

(13 citation statements)

References 10 publications

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“…Despite considerable research, treatment remains unsatisfactory. In attempting to achieve more specificity in the search for treatment alternatives, single psychotic symptoms have been investigated [3][4][5][6]. The most prominent example is auditory verbal hallucinations.…”

Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic Stimulation for Positive Symptoms in Schizophrenia: A Systematic Review

et al. 2019

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Transcranial magnetic stimulation (TMS) has been proposed as a potential treatment add-on for positive symptoms in schizophrenia. To summarize the current evidence for its efficacy, we reviewed clinical trials from the last 20 years that investigated TMS for positive symptoms. We performed a search on the PubMed database for clinical trials that used TMS for the treatment of positive symptoms published in peer-reviewed journals. We excluded reviews, case reports, and opinion papers. Of the 30 studies included, the majority (<i>n</i> = 25) investigated auditory verbal hallucinations. Twelve studies found evidence for a positive treatment effect of TMS on positive symptoms, while 18 did not find enough evidence to conclude that TMS is effective for positive symptoms. However, the small sample size of the majority of studies is a limiting factor for the reliability of previous findings. In conclusion, evidence for an effect of TMS on positive symptoms was mixed. Since most of the studies were performed in patients with auditory verbal hallucinations, further research of TMS for other positive symptoms including thought disorder and delusions is warranted.

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Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic Stimulation for Positive Symptoms in Schizophrenia: A Systematic Review

et al. 2019

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“…A small number of studies that parse these 2 dimensions identify structural deficits that extend beyond the language network (Palaniyappan et al, 2015; Sans-Sansa et al, 2013) in negative FTD. Nevertheless, the structural basis of positive FTD continues to be elusive in most studies (Cavelti et al, 2018b; Palaniyappan et al, 2015; Winkelbeiner et al, 2018; but see Sans-Sansa et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Cortical thickness and formal thought disorder in schizophrenia: An ultra high-field network-based morphometry study

Palaniyappan

Al-Radaideh

Gowland

et al. 2019

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Background: Persistent formal thought disorder (FTD) is a core feature of schizophrenia. Recent cognitive and neuroimaging studies indicate a distinct mechanistic pathway underlying the persistent positive FTD (pFTD or disorganized thinking), though its structural determinants are still elusive. Using network-based cortical thickness estimates from ultra-high field 7-Tesla Magnetic Resonance Imaging (7T MRI), we investigated the structural correlates of pFTD. Methods: We obtained speech samples and 7T MRI anatomical scans from medicated clinically stable patients with schizophrenia (n=19) and healthy controls (n=20). Network-based morphometry was used to estimate the mean cortical thickness of 17 functional networks covering the entire cortical surface from each subject. We also quantified the vertexwise variability of thickness within each network to quantify the spatial coherence of the 17 networks, estimated patients vs. controls differences, and related the thickness of the affected networks to the severity of pFTD. Results: Patients had reduced thickness of the frontoparietal and default mode networks, and reduced spatial coherence affecting the salience and the frontoparietal control network. A higher burden of positive FTD related to reduced frontoparietal thickness and reduced spatial coherence of the salience network. The presence of positive FTD, but not its severity, related to the reduced thickness of the language network comprising of the superior temporal cortex. Conclusions: These results suggest that cortical thickness of both cognitive control and language networks underlie the positive FTD in schizophrenia. The structural integrity of cognitive control networks is a critical determinant of the expressed severity of persistent FTD in schizophrenia.

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“…24 These symptoms are frequent, but often underreported by patients and undernoticed as well as undertreated by clinicians. 25,26 They furthermore might lead to loss in quality of life and might be a reason for treatment discontinuation 1,27 and illness relapse, which together with persistent positive symptoms 28–31 may severly impact recovery and therapeutic alliance. 32 Prolongation of QTc was observed in 7 of 14 antipsychotics compared by placebo in the intergroup comparision by Huhn and colleagues.…”

Section: Introductionmentioning

confidence: 99%

Examining side effect variation in antipsychotic treatment and schizophrenia spectrum disorders

Neumeier

Homan

Vetter

et al. 2020

Preprint

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Background: Side effects of antipsychotic drugs play a key role in non-adherence and discontinuation of treatment in schizophrenia spectrum disorders (SSD). Precision medicine aims to minimize such side effects by selecting the right treatment for the right patient. However, to determine the extent of precision medicine that is required, we need to (1) show that there is indeed variation in side effects and (2) estimate the amount of variation in those side effects between patients. While clinical observations suggest that such variation may be considerable, a statistical comparison of side effect variation between active and control treatments is required to confirm this. Here, we hypothesized to find larger side effect variation in treatment compared with control in patients treated with first and second generation antipsychotics. Methods: We included double-blind, placebo-controlled, randomized controlled trials (RCTs) of adults with a diagnosis of SSD and prescription for licensed antipsychotic drugs. Standard deviations of the pre-post treatment differences of weight gain, prolactin levels,and corrected QT (QTc) times were extracted. Data quality and validity were ensured by following the PRISMA guidelines. The outcome measure was the overall variability ratio of treatment to control across RCTs. Individual variability ratios were weighted by the inverse-variance method and entered into a random-effects model. Results: We included N = 16578 patients for weight gain, N = 16633 patients for prolactin levels, and N = 10384 patients for QTc time. Variability ratios (VR) were significantly increased for weight gain (VR = 1.08; 95% CI: 1.02 - 1.14; P = 0.004) and prolactin levels (VR = 1.38; 95% CI: 1.17 - 1.62; P < 0.001) but did not reach significance for QTc time (VR = 1.05; 95% CI: 0.98 - 1.12; P = 0.135). Conclusion: We found increased variability in major side effects in patients with SSD under treatment with second generation antipsychotics, suggesting that subgroups of patients or even individual patients may benefit from improved treatment allocation through stratified or personalized medicine, respectively.

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Decreased blood flow in the right insula and middle temporal gyrus predicts negative formal thought disorder in schizophrenia

Cited by 15 publications

References 10 publications

Transcranial Magnetic Stimulation for Positive Symptoms in Schizophrenia: A Systematic Review

Transcranial Magnetic Stimulation for Positive Symptoms in Schizophrenia: A Systematic Review

Cortical thickness and formal thought disorder in schizophrenia: An ultra high-field network-based morphometry study

Examining side effect variation in antipsychotic treatment and schizophrenia spectrum disorders

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