Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions

World Psychiatry, Journal Year: 2024, Volume and Issue: 23(1), P. 26 - 51

Published: Jan. 12, 2024

Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it faced challenges criticisms, most notably a lack clinical translation. This paper provides comprehensive review critical summary literature on functional neuroimaging, in particular magnetic resonance imaging (fMRI), We begin by reviewing research fMRI biomarkers schizophrenia high risk phase through historical lens, moving from case-control regional brain activation to global connectivity advanced analytical approaches, more recent machine learning algorithms identify predictive features. Findings studies negative symptoms as well neurocognitive social cognitive deficits are then reviewed. neural markers these may represent promising treatment targets Next, we summarize related antipsychotic medication, psychotherapy psychosocial interventions, neurostimulation, including response resistance, therapeutic mechanisms, targeting. also utility data-driven approaches dissect heterogeneity schizophrenia, beyond comparisons, methodological considerations advances, consortia precision fMRI. Lastly, limitations future directions field discussed. Our suggests that, order for be clinically useful care patients should address potentially actionable decisions that routine treatment, such which prescribed or whether given patient is likely have persistent impairment. The potential influenced must weighed against cost accessibility factors. Future evaluations prognostic consider health economics analysis.

Language: Английский

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Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis

Schizophrenia Bulletin, Journal Year: 2024, Volume and Issue: 50(3), P. 496 - 512

Published: March 7, 2024

Abstract This article describes the rationale, aims, and methodology of Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). is largest international collaboration to date that will develop algorithms predict trajectories outcomes individuals at clinical high risk (CHR) for psychosis advance development use novel pharmacological interventions CHR individuals. We present a description participating research networks data processing analysis coordination center, their processes harmonization across 43 sites from 13 countries (recruitment North America, Australia, Europe, Asia, South America), flow quality assessment processes, analyses, transfer National Institute Mental Health (NIMH) Data Archive (NDA) by community. In an expected sample approximately 2000 640 matched healthy controls, AMP SCZ collect clinical, environmental, cognitive along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech facial expression samples, measures derived digital health technologies smartphone-based daily surveys, passive sensing as well actigraphy. The study investigate range over 2-year period, transition psychosis, remission or persistence status, attenuated positive symptoms, persistent negative mood anxiety psychosocial functioning. global reach its harmonized innovative methods promise catalyze new treatments address critical unmet public needs in

Language: Английский

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Sample ascertainment and clinical outcome measures in the Accelerating Medicines Partnership® Schizophrenia Program

Schizophrenia, Journal Year: 2025, Volume and Issue: 11(1)

Published: April 3, 2025

Clinical ascertainment and clinical outcome are key features of any large multisite study. In the ProNET PRESCIENT research networks, Accelerating Medicines Partnership® Schizophrenia (AMP®SCZ) Ascertainment Outcome Measures Team aimed to establish a harmonized assessment protocol across these two networks define criteria primary secondary endpoints. addition developing protocol, goals this aspect AMP SCZ project were: (1) implement monitor training, participants, assessments; (2) provide expert input Psychosis Risk Evaluation, Data Integration Computational Technologies: Processing, Analysis, Coordination Center (PREDICT-DPACC) for data collection, quality control, preparation analysis measures; (3) ongoing support analysis, reporting data. This paper describes endpoints outcomes, rationale selection measures, extensive training staff, (4) measures study which includes several sites where English is not native language; (5) measure stability over time in observational comparing ratings at baseline 2-month follow up. Watch Dr. Jean Addington discuss her work article: https://vimeo.com/1040425281 .

Language: Английский

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Cognitive assessment in the Accelerating Medicines Partnership® Schizophrenia Program: harmonization priorities and strategies in a diverse international sample

Schizophrenia, Journal Year: 2025, Volume and Issue: 11(1)

Published: March 24, 2025

Cognitive impairment occurs at higher rates in individuals clinical high risk (CHR) for psychosis relative to healthy peers, and it contributes unique variance multivariate prediction models of transition psychosis. Such is considered a core biomarker schizophrenia. Thus, cognition key domain measured the Accelerating Medicines Partnership® program Schizophrenia (AMP SCZ initiative). The aim this paper describe rationale, processes, considerations, final harmonization cognitive battery used AMP across two data collection networks. This comprises tests general intellect specific domains. We estimate premorbid intelligence baseline measure current 2 years. Eight from Penn Computerized Neurocognitive Battery (PennCNB), which verbal learning memory, sensorimotor ability, attention, emotion recognition, working processing speed, visual motor speed are administered repeatedly baseline, four follow-up timepoints over

Language: Английский

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Development of the PSYCHS: Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS

Early Intervention in Psychiatry, Journal Year: 2023, Volume and Issue: 18(4), P. 255 - 272

Published: Aug. 28, 2023

Abstract Aim To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome psychosis (CHR‐P): Structured Interview Psychosis‐risk Syndromes (SIPS) Comprehensive Assessment of At‐Risk Mental States (CAARMS). Methods The initial workshop is described in companion report from Addington et al. After workshop, lead experts each instrument continued harmonizing attenuated positive symptoms criteria CHR‐P through an intensive series joint videoconferences. Results Full harmonization was achieved symptom ratings criteria, modest criteria. semi‐structured interview, named Positive SYmptoms Diagnostic Criteria CAARMS Harmonized with SIPS (PSYCHS), generates scores both SIPS. Conclusions Using PSYCHS ascertainment, conversion determination, will help comparing findings across studies meta‐analyses.

Language: Английский

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The Genesis of Schizophrenia: An Origin Story

American Journal of Psychiatry, Journal Year: 2024, Volume and Issue: 181(6), P. 482 - 492

Published: June 1, 2024

Schizophrenia is routinely referred to as a neurodevelopmental disorder, but the role of brain development in disorder typically diagnosed during early adult life enigmatic. The authors revisit model schizophrenia with genomic insights from most recent clinical genetic association studies, transcriptomic and epigenomic analyses human postmortem cellular models that recapitulate neurodevelopment. Emerging into risk continue converge on development, particularly stages may be perturbed deviate typical, normative course, resulting symptomatology. As explicate, likely dynamic context dependent, effects varying spatiotemporally, across continuum. Optimizing therapeutic strategies for heterogeneous collective individuals guided by leveraging markers derivative functional insights, well before emergence psychosis. Ultimately, rather than focus intervention adolescence or adulthood, principles prediction prophylaxis pre- perinatal neonatal best comport biology address early-stage perturbations alter trajectory.

Language: Английский

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Negative symptoms and social cognition as mediators of the relationship between neurocognition and functional outcome in schizophrenia

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: Jan. 31, 2024

Introduction In this study we assessed the contribution of psychopathology, including two domains negative symptoms (motivational deficit and expressive deficit), processing speed as an index neurocognition, emotion recognition, social cognition, to poor functional outcomes in people with schizophrenia. Methods The Positive Negative Syndrome Scale was used evaluate positive disorganization Brief Symptom assess symptoms. Symbol Coding Trail Making Test A B were rate Facial Emotion Identification recognition. Functional outcome Personal Social Performance (PSP). Regression analyses performed identify predictors outcome. Mediation investigate whether cognition symptom fully or partially mediated impact on Results One hundred fifty subjects from 8 different European centers recruited. Our data showed that predicted global functioning together motivational effects neurocognition it. Motivational a predictor personal neurocognitive impairment same Both socially useful activities, recognition domain deficits Conclusions results indicate pathways are specific for real-life mediate functioning. suggest both should be targeted by psychosocial interventions enhance remediation.

Language: Английский

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On the proportion of patients who experience a prodrome prior to psychosis onset: A systematic review and meta-analysis

Molecular Psychiatry, Journal Year: 2024, Volume and Issue: 29(5), P. 1361 - 1381

Published: Feb. 2, 2024

Language: Английский

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Emergence and dynamics of delusions and hallucinations across stages in early psychosis

Biological Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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Data analysis strategies for the Accelerating Medicines Partnership® Schizophrenia Program

Schizophrenia, Journal Year: 2025, Volume and Issue: 11(1)

Published: April 3, 2025

The Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ) project assesses a large sample of individuals at clinical high-risk for developing psychosis (CHR) and community controls. Subjects are enrolled in 43 sites across 5 continents. assessments include domains similar to those acquired previous CHR studies along with novel that collected longitudinally period 2 years. In parallel the data acquisition, multidisciplinary teams experts have been working formulate analysis strategy AMP SCZ project. Here, we describe key principles analysis. primary aim is use baseline multimodal biomarkers predict endpoints individuals. These defined study as transition (i.e., conversion), remission from syndrome, persistent syndrome (non-conversion/non-remission) obtained one year two years after assessment. secondary longitudinal all time points identify trajectories differentiate subgroups design plan informed by reviewing legacy analytic approaches international studies. addition, consider properties newly distinct available data. Legacy used assist pipeline building, perform benchmark experiments, quantify concepts make decisions meant overcome challenges encountered We present project, mitigation strategies address related plan, provide rationales decisions, examples how support Watch Prof. Ofer Pasternak discuss his work this article: https://vimeo.com/1023394132?share=copy#t=0 .

Language: Английский

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