Reconsidering brain tissue changes as a mechanistic focus for early intervention in psychiatry

Palaniyappan, Lena; Sukumar, Niron

doi:10.1503/jpn.200172

Cited by 6 publications

(6 citation statements)

References 81 publications

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“…This developmental plasticity or reorganization process occurs mostly right after the illness onset and at early disease course 51 . From this perspective, structural changes due to reorganization are likely to be modulated by factors that impact the brain plasticity resulting in both tissue volume increase and/or decrease 52 . Reframing the view on structural changes, as mentioned previously, may lend insight into cases where functional outcomes do not align with volumetric deficiencies, for example, some studies found greater volumes in the Sub and CA1 of BPD patients with childhood trauma than without, despite childhood trauma being a demonstrated risk factor for these subfields 50,53 .…”

Section: Discussionmentioning

confidence: 99%

Subfield‐specific longitudinal changes of hippocampal volumes in patients with early‐stage bipolar disorder

et al. 2023

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Bipolar affective disorder (BPD) is associated with cognitive deficits and brain structural aberrations, including hippocampal abnormalities, 1 which are proposed to play a fundamental role in the etiology of psychotic symptoms. 2 The hippocampal formation is a key component of the limbic system involved in numerous cognitive functions including pattern separation/completion and input integration, which contribute to the incorporation of newly formed memories. 3 The hippocampus is a heterogeneous structure composed of biologically and functionally distinct subfields, namely the cornu ammonis (CA) 1-4, subiculum (Sub) complex, and dentate gyrus (DG). 4 Additionally, there is a functional segregation along the longitudinal axis, where the anterior portions of the hippocampus are highly

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Section: Discussionmentioning

confidence: 99%

Subfield‐specific longitudinal changes of hippocampal volumes in patients with early‐stage bipolar disorder

et al. 2023

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“…2016 ; Cropley et al. 2017 ; Palaniyappan and Sukumar 2020 ). The locations of cortical changes identified here also largely coincide with results from previous histological and MRI studies of myelin abnormalities in SSD ( Takahashi et al.…”

Section: Discussionmentioning

confidence: 99%

“…2014 ). It has also been suggested that the structural changes in psychiatric disorders observed after disease onset may be considered as adaptive “cortical reorganization” instead of progressive pathology ( Palaniyappan and Sukumar 2020 ). Therefore, increased cortical myelin may represent further neuroadaptation that occurs in response to existing deficits.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Macromolecular Proton Fraction Mapping Reveals Altered Cortical Myelin Profile in Schizophrenia Spectrum Disorders

Sui

Bertisch

Lee

et al. 2021

Cerebral Cortex Communications

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Myelin abnormalities have been reported in schizophrenia spectrum disorders (SSD) in white matter. However, in vivo examinations of cortical myeloarchitecture in SSD, especially using quantitative measures, are limited. Here we employed macromolecular proton fraction (MPF) obtained from quantitative magnetization transfer imaging to characterize intracortical myelin organization in 30 SSD patients versus 34 healthy control (HC) participants. We constructed cortical myelin profiles by extracting MPF values at various cortical depths and quantified their shape using a nonlinearity index (NLI). To delineate the association of illness duration with myelin changes, SSD patients were further divided into three duration groups. Between-group comparisons revealed reduced NLI in the SSD group with the longest illness duration (>5.5 years) compared to HC predominantly in bilateral prefrontal areas. Within the SSD group, cortical NLI decreased with disease duration and was positively associated with a measure of spatial working memory capacity as well as with cortical thickness. Layer specific analyses suggested that NLI decreases in the long duration SSD group may arise in part from significantly increased MPF values in the midcortical layers. The current study reveals cortical myelin profile changes in SSD with illness progression, which may reflect an abnormal compensatory mechanism of the disorder.

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“…Structural changes are temporally constrained to the early post-onset phase, spatially constrained to selected regions and include both tissue loss and tissue gain (Palaniyappan, 2017). A substantial amount of these changes could indeed be compensatory, representing a reorganisation response to the illness, as argued elsewhere (Palaniyappan and Sukumar, 2020). Thus, the horseman, even if he exists, may not intend the imagined harm.…”

Section: The Headless Horsemanmentioning

confidence: 98%

The neuroscience of early intervention: Moving beyond our appeals to fear

Palaniyappan

2021

Aust N Z J Psychiatry

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This viewpoint is a continuation of the debate on the early intervention movement in psychiatry. The criticisms of Malhi and colleagues have generated some fundamental questions about the priorities of the early intervention movement and the need for further work. In particular, the summons sent to neuroscience need to be more specific in the near future. We may be doing well with what we have, but more directed efforts are needed to purposefully seek what we do not.

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Reconsidering brain tissue changes as a mechanistic focus for early intervention in psychiatry

Cited by 6 publications

References 81 publications

Subfield‐specific longitudinal changes of hippocampal volumes in patients with early‐stage bipolar disorder

Subfield‐specific longitudinal changes of hippocampal volumes in patients with early‐stage bipolar disorder

Quantitative Macromolecular Proton Fraction Mapping Reveals Altered Cortical Myelin Profile in Schizophrenia Spectrum Disorders

The neuroscience of early intervention: Moving beyond our appeals to fear

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