bluuebunny/crossref_metadata_2025 huggingface dataset:
T149. CARDIOVASCULAR RISK AND VASCULAR AGE IN ADULTS WITH SCHIZOPHRENIA COMPARED TO A HEALTHY POPULATION: DATA FROM CORTEX-SP STUDY
Authors: Tous-Espelosin Mikel , Iriarte-Yoller Nagore , MartinezAguirre-Betolaza Aitor , Hervella Isabel , Corres Pablo , Pavón Cristobal , Arratibel-Imaz Iñaki , Elizagárate Edorta , Sanchez Pedro , Sanpedro Agurne , de Zárate Amaia Ortiz , Ojeda Natalia , Peña Javier , Ibarretxe-Bilbao Naroa , Maldonado-Martin Sara
Published: May 2020

Background

Cardiovascular disease (CVD) is the most common cause of death in people with schizophrenia (SP). The European guidelines on CVD prevention recommend that people with high levels of individual risk factors should automatically have all their risk factors actively managed. It is suggested that CVD risk in SP should be assessed by general risk charts and to include specific relative risk chart for people with severe mental illnesses. Therefore, the purpose of the present study was to estimate CVD risk and vascular age in adults with SP and compared them with a healthy sample.

Methods

A total of 85 participants with SP (16.2% women, 42.1±10.0 yr old) were compared with 30 HEALTHY participants (60.0% women, 40.0±9.0 yr old). CVD risk was calculated using Systematic Coronary Risk Estimation (SCORE), Framingham Heart Score-Cardiovascular Disease (FRS-CVD), relative risk SCORE and vascular age. Likewise, the variables assessed to calculate the risk charts were age, body mass index, smoking percentage, systolic blood pressure (SBP) through ambulatory blood pressure monitoring during 24 hours and through a fasting biochemical profile, high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC).

Results

All HEALTHY variables were in normal values. Sample with SP showed overweight (body mass index=27.1±6.1 kg∙m-2) and higher (P<0.001) smoking percentage than HEALTHY (69.8% vs. 16.1%). Both groups presented normotensive SBP values (SP=115±15 mmHg, HEALTHY=113±10 mmHg). Concerning cholesterol profile, SP showed lower to optimal values in HDL-C (39.0±12.0 mg/dL), yet both were in optimal TC levels (SP=189.7±44 mg/dL, HEALTHY=183.6±35.1 mg/dL). Considering SCORE, both groups were in low risk values with higher (P<0.001) values in SP (0.6±1.0 vs. 0.1±0.4). However, according to relative risk SCORE and FRS-CVD, SP showed medium risk (2.0±1.0; 6.7±12.3), and HEALTHY low (1.0±0.4; 2.6±2.8) risk, respectively. Vascular age was higher (P<0.001) in SP than HEALTHY (48.0±26.0 vs. 36.0±24.0 yr).

Discussion

Patients suffering from SP compared to HEALTHY showed higher CVD risk and vascular age. These results strongly suggest the promotion of a healthy lifestyle behavior in order to optimize risk factors.
T166. VISUALIZATION OF AMPA RECEPTORS IN PATIENTS WITH SCHIZOPHRENIA AND DEPRESSION: THE FIRST PET IMAGING STUDY
Authors: Uchida Hiroyuki , Miyazaki Tomoyuki , Nakajima Waki , Hatano Mai , Tani Hideaki , Nagai Nobuhiro , Koizumi Teruki , Nakajima Shinichiro , Mimura Masaru , Takahashi Takuya
Published: May 2020

Background

Evidence on physiological roles of AMPA receptors in psychiatric conditions, including schizophrenia, has been accumulated, which mainly derives from psychiatric disease model animals as well as post-mortem brain tissues. However, its clinical translation was limited due to lack of any tool to visualize AMPA receptors in living human brain. We have recently developed a new positron emission tomography (PET) probe for AMPA receptors (Miyazaki et al. Nature Medicine, in press). Here, we used the first PET probe that specifically binds to AMPA receptors and successfully visualized these receptors in living human brain of patients with schizophrenia.

Methods

We developed a novel PET probe for AMPARs, named [11C]K-2 (Miyazaki et al. Nature Medicine, in press). Male patients aged 30–49 with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) underwent a [11C]K-2 PET scan and an MRI scan for co-registration of the PET image and received clinical assessments for symptomatology, including the Positive and Negative Syndrome Scale (PANSS) (registration number: UMIN000025132).

[11C]K-2 was synthesized at Yokohama City University Hospital in accordance with GMP ordinance and was certified by the Japanese Society of Nuclear Medicine. PET imaging was performed with a TOSHIBA Aquiduo scanner (TOSHIBA Medical), which provided an axial FOV of 240 mm, and 80 contiguous 2.0 mm thick slices. Standardized uptake value ratio (SUVR)30–50 min with the whole brain and white matter as a reference was calculated, respectively.

Results

Ten subjects with schizophrenia (mean±SD age, 43.1±3.1 years; duration of illness, 16.8±8.0 years; PANSS total score, 61.7±13.4) participated in this study. There were negative correlations between SUVR30-50 min with the whole brain as a reference in the cingulate gyrus and parahippocampus and PANSS total scores according to the voxel-wise analysis. These correlations were not observed when the while matter was used as a reference.

Discussion

[11C]K-2 has revealed distinct distribution patterns of AMPA receptors for schizophrenia. Thus, [11C]K-2 is proven to be a potent PET tracer that can be used to visualize AMPARs with high contrast, leading to the elucidation of the molecular mechanisms of schizophrenia.
T171. HIGH POLYGENIC BURDEN IS ASSOCIATED WITH BLOOD DNA METHYLATION CHANGES IN INDIVIDUALS WITH SUICIDAL BEHAVIOR
Authors: Cabrera Brenda , Martínez-Magaña José Jaime , Mendoza Alma Delia Genis , Sarmiento Emmanuel , Ruíz-Ramos David , Tóvilla-Zarate Carlos Alfonso , González-Castro Thelma Beatriz , Juárez-Rojop Isela Esther , García-de la Cruz Dulce Dajheanne , López-Armenta Mauro , Real Fernanda , García-Dolores Fernando , Flores Gonzalo , Vázquez-Roque Rubén Antonio , Lanzagorta Nuria , Escamilla Michael , Saucedo-Uribe Erasmo , Rodríguez-Mayoral Oscar , Jiménez-Genchi Janet , Castañeda-González Carlos , Roche-Bergua Andrés , Nicolini Humberto
Published: May 2020

Background

Suicidal behavior may be divided into completed suicide, suicide attempts, and suicidal ideation. It has been suggested that these behaviors represent a continuum and result from the interaction of several contributors, including genetic and environmental factors. The integration of approaches considering the polygenic component of suicidal behavior, such as polygenic risk scores (PRS) and DNA methylation is promising for improving our understanding of the complex interplay between genetic and environmental factors in this behavior. The aim of this study was the evaluation of DNA methylation differences between individuals with high and low genetic burden for suicidality.

Methods

The present study was divided into two phases. In the first phase, genotyping with the Psycharray chip was performed in a discovery sample of 568 Mexican individuals, of which 149 had suicidal behavior (64 individuals with suicidal ideation, 50 with suicide attempt and 35 with completed suicide) and 419 non-suicide controls. Then, a PRS analysis based on summary statistics from the Psychiatric Genomic Consortium was performed in the discovery sample. In a second phase, we evaluated DNA methylation differences between individuals with high and low genetic burden for suicidality in a sub-sample of the discovery sample (target sample) of 94 subjects. Methylation profile from individuals in the target sample was assessed with the Illumina Infinium Human Methylation EPIC BeadChip.

Results

We identified 153 differentially methylated sites between individuals with low and high-PRS. From these, 91 sites were hypermethylated and 62 hypomethylated in the high PRS group relative to low PRS group. Among genes mapped to differentially methylated sites, we found genes involved in neurodevelopment and ATP binding.

Discussion

To our knowledge, this is the first study integrating polygenic risk scores and DNA methylation in suicidality. Our results suggest that genetic variants might increase the predisposition to epigenetic variations in genes involved in neurodevelopment. This study highlights the possible implication of polygenic burden in the alteration of epigenetic changes in suicidal behavior.
T179. WHEN TOO LITTLE IS TOO MUCH: TEMPORARY PREFRONTAL MICROGLIA DEFICIENCY DURING ADOLESCENCE IMPAIRS ADULT BRAIN FUNCTIONS
Authors: Schalbetter Sina-Maria , Dawson Kara , Müller Flavia , Scarborough Joseph , Weber-Stadlbauer Ulrike , Ivanov Andranik , Mattei Daniele , Richetto Juliet , Notter Tina , Meyer Urs
Published: May 2020

Background

Aberrant activity of microglia, the primary innate immune cells of the brain parenchyma, may play a role in the etiology and pathophysiology of schizophrenia and related disorders. While current immunopsychiatric research indicates that microglial hyperactivity may contribute to psychotic illness in some cases, the diametrical opposite (i.e. microglial hypoactivity) may be pathologically and therapeutically relevant for others. The latter hypothesis, however, remains largely unexplored and thus warrants investigation.

Methods

We aimed at developing a model system in mice, in which the short- and long-term effects of selective, temporary and local depletion of microglia can be studied experimentally. This model system is based on intracerebral injection of clodronate disodium salt (CDS) into selected brain areas of interest. The behavioral and cognitive effects of temporary microglia depletion in the adolescent medial frontal cortex (mPFC) were assessed after full microglia recovery in adulthood. In addition, genome-wide transcriptional profiling was conducted during the peak of microglia depletion and after full microglia recovery in the mPFC.

Results

We show that a single intracerebral injection of CDS is a suitable and efficient approach to selectively deplete microglia without affecting astrocytes and neurons in-vivo, leading to a robust (~ 80% depletion) but temporary (~ 1 week) microglia deficiency in selected brain areas of interest. Using this model, we further demonstrate that CDS injection into mPFC during late adolescence (6 weeks of age) causes numerous mPFC-related cognitive dysfunctions in adulthood, that is, when microglial cells have been fully restored again. The spectrum of cognitive deficits included impairments in social recognition memory, temporal order memory and extinction of conditioned fear responses. These deficits emerged similarly in male and female animals and were paralleled by a permanent transcriptional dysregulation of genes relevant for synaptic refinement and stability. Intriguingly, CDS injections into the mPFC during early adolescence (4 weeks of age) or adulthood (12 weeks of age) did not induce similar cognitive dysfunctions in adulthood.

Discussion

Taken together, the present data demonstrate that temporary prefrontal microglia deficiency during adolescence leads to permanent cognitive impairments in adulthood. Our findings further highlight that distinct adolescent stages of cortical maturation show a differing sensitivity towards the long-term cognitive effects of temporary microglia hypoactivity.
T187. ATHENS MULTIFAMILY THERAPY PROJECT THE ATHENS MULTIFAMILY THERAPY PROJECT (A- MFTP) PROVIDES SYSTEMIC MULTIFAMILY GROUP THERAPY TO YOUTHS WHO EXPERIENCED A FIRST PSYCHOTIC EPISODE (FEP) AND THEIR FAMILIES
Authors: Selakovic Mirjana , Galanis Dimitris , Frankiadaki Eva , Theodoropoulou Pica , Pomini Valeria
Published: May 2020

Background

The Athens multifamily therapy project (A- MFTP) provides systemic multifamily group therapy to youths who experienced a first psychotic episode (FEP) and their families. The participants were partly recruited from the ongoing longitudinal Early and Long-term Psychosis Intervention Study –ELPIS, Athens FEP Project, which aims to investigate the involvement of genetic and environmental determinants on psychosis risk.

Methods

A group of five families with a child who had experience FEP, attended two multifamily group sessions per month, in the time period from September 2017 to Jun 2018. Parents and offspring participated to the sessions, which were conducted by two co-therapists. Monthly supervision was provided. Assessment of patients’ psychopathology was based on PANSS at baseline, end of therapy and 6-month follow-up. All participants fulfilled an instrument assessing family factors (SCORE-15) and the Reflective Functioning Questionnaire (RFQ) at the same three time points. Furthermore, participants were asked to give written opinions regarding the therapeutic process at the middle phase, the end of therapy and six months follow - up. Written feedback and reflections on the group therapy sessions were periodically filled by the therapists.

Results

A qualitative analysis identified the emerging themes and patterns, focusing on the language and the meaning constitutes. Communication techniques, emotional processing and problem solving were the main learnings for the members of the group. They highlighted the impact of the group processes on family communication and individual understanding, while the development of a “new family” emerged from the group relationships

Discussion

A- MFTP seems to be a promising service aiming to improve mental health and wellbeing of participants, to contrast chronicity and to contribute to early intervention services for psychoses in Greece.
T188. THE CLINICAL SCIENCE OF TRANSCRANIAL DIRECT CURRENT STIMULATION STUDIES IN SCHIZOPHRENIA: SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Mervis Joshua , MacDonald Angus
Published: May 2020

Background

Transcranial direct current stimulation interventions have produced findings that inform clinical neuroscience, and may have potential as a treatment for the cognitive symptoms of schizophrenia-spectrum illnesses. The first recorded study of tDCS in this population was in 1994 and every year since then has seen growth in the number of studies conducted, with 15+ studies each year since 2013. This project is a meta-analysis of studies using transcranial direct current stimulation in people with schizophrenia-spectrum illnesses and any domain of cognition.

Methods

Search terms sought out articles in populations with schizophrenia, schizoaffective, schizotypal, schizoid, unspecified psychosis, and thought disorder illnesses. Within these populations, non-invasive electrical stimulation terms included transcranial direct current stimulation, tDCS, and transcranial electrical stimulation. Within those studies, cognitive terms included working memory, memory, cognitive control, executive function, attention, recall, recognition, perception, learning, cognition, inhibition, and executive control. PRISMA guidelines were followed.

Results

177 Articles were located through a literature search using the PubMed database. 39 studies were screened out by title, 102 studies were screened out by abstract, 7 studies were screened out by text. Finally, 29 studies were subjected to meta-analysis.

Discussion

While the research on transcranial direct current stimulation continues to develop, the current study highlights methodological trends like studies with stimulation concurrent to task and those using training approaches. Overall effects are summarized by defining study characteristics and cognitive domains, where appropriate.
T191. FRONTO-CORTICAL ROLES OF NIGELLA SATIVA IN SOCIALLY ISOLATED MICE
Authors: Folarin Royhaan , Otenaike Bolaji , Samuel Goodness , Bakare Falilat , Onamusi Barnabas , Abdurasheed Usman
Published: May 2020

Background

Schizophrenia is a chronic debilitating mental disorder, modelled developmentally in animals by social isolation rearing (SIR). This study investigated the roles of Nigella sativa, a multi-therapeutic plant oil, on the fronto-cortical functions and alterations in socially isolated BALB/c mice.

Methods

Body weights, relative brain weights, dopamine, glutamate and GPX levels, as well as recognition memory were measured in 75 albino pups of 10 weeks age. These pups were divided into CTRL,NS,SIR, SIR NS and NS SIR. CTRL (socialised) and SIR (isolated) received 10ml/kg normal saline orally for 10 days, while the NS-SIR, NS and SIR-NS received 1ml/kg Nigella sativa oil orally for 10 days either prophylactically (prenatal exposure), alone without isolation, or interventionally respectively. Recognition memory was assayed through novel object recognition test and the animals were euthanized. Brains were excised for histological examination of the frontal Cortex using the H&E stain.

Results

Significant increase (p<0.05) in fronto-cortical glutamate, dopamine, and glutathione peroxidase (GPX), as well as recognition memory index, relative brain weight and total body weights were recorded in the isolated mice that were pre-treated and post-treated with Nigella sativa, compared with the untreated ones. However, no significant neuroarchitectural difference was observed histologically across the frontal cortices of the mice.

Discussion

Nigella sativa was significantly prophylactic and ameliorative of the neurochemical and neurobehavioural schizotypic deficits induced in socially isolated BALB/c mice. This was revealed by glutamate, dopamine, GPX, recognition index and relative brain weight values of the pretreated and post-treated mice. Use of dendritic and Nissl markers are recommended for better histological appreciation
M118. FACTOR STRUCTURE OF THE CLINICIAN-RATED DIMENSION OF PSYCHOSIS SYMPTOM SEVERITY IN PATIENTS WITH EARLY PSYCHOSIS
Authors: Lee Kyuyoung , Sik Kim Yong
Published: May 2020

Background

The early psychosis is classically viewed as a critical period. Schizophrenia subtypes which had been used to describe heterogeneity of the disease were discarded with the release of DSM-5 because of the lack of their clinical significance. DSM-5 has proposed the use of the Clinician-Rated Dimension of Psychosis Symptom Severity (CRDPSS) for evaluating the various symptoms of schizophrenia. The 8-domain CRDPSS was developed from the perspective of deconstructing the psychopathology of schizophrenia and would be expected to provide baseline data for further advances in psychiatric nosology. To our knowledge, despite these discussions, the dimensional structure of the CRDPSS has hardly been studied in the patients with early psychosis. The purpose of this study is to investigate the structure categorizing the items of dimensional assessment through factor analysis in patients with early psychosis.

Methods

The subjects were 497 patients with early psychosis who were enrolled in the Korean Early Psychosis Cohort Study. They were between ≥18 years and ≤45 years of age who fulfill the criteria of DSM-5 for schizophrenia spectrum and other psychotic disorders. In KEPS, early psychosis was defined the patients whose duration of treatment were within 2 years. The proportion of males was 41.9% and their mean age and age at onset were 28.7(SD=8.9) and 26.8(SD=9.1) years, respectively. An exploratory factor analysis(EFA) was conducted on the 8 items of dimensional assessment of psychosis in DSM-5 with principle components extracted by the varimax method.

Results

An exploratory factor analysis(EFA) was conducted on the items of dimensional assessment of psychosis in DSM-5 with principle components extracted by the varimax method. Two factors were identified which were labeled as ‘psychotic’ and ‘deficit’ domain. The first factor included delusions (loading=0.834, communality=0.697), hallucinations(loading=0.800, communality=0.640), disorganization(loading=0.654, communality=0.642), and abnormal psychomotor behavior(loading=0.677, communality=0.549). The second factor included negative symptoms(loading=0.833, communality=0.703) and impaired cognition(loading=0.827, communality=0.697). Depression and mania were excluded in factor analysis due to statistical incompatibility such as lack of communality less than 0.4. Bartlett’s test for sphericity was significant (χ2 =817.996, p<0.001), and the total variance of the factor solution was 65.452%.

Discussion

Two factors were identified which were labeled as ‘psychotic’ and ‘deficit’ domain. The first factor included delusions, hallucinations, disorganization and abnormal psychomotor behavior. The second factor included negative symptoms and impaired cognition. To our knowledge, this study is the first attempt to analyze the early psychosis patients using the dimensional assessment of psychosis in DSM-5, and it would be meaningful to follow up the course with the cohort.
M123. EPISODIC VERBAL MEMORY DEFICIT IN SCHIZOPHRENIA: A MARKER OF PROGRESSION OF DISEASE OR DIFFERENT NEURODEVELOPMENTAL PATHWAYS FROM THE ONSET?
Authors: Reckziegel Ramiro , dos Santos Martins Dayane , Correa de Sales Sarah , Stephane de Jesus Letícia , Philippsen Marieli , Massuda Raffael , Amoretti Silvia , Garcia Clemente , Sanguinetti Czepielewski Letícia , Severino Gama Clarissa
Published: May 2020

Background

Episodic verbal memory primarily indicates acquisition or registration of memory for verbally presented information, being one of the main neuropsychological impaired functions in individuals with schizophrenia. Furthermore, it appears to be more susceptible than other memory systems to early neuronal dysfunction, supporting hypotheses about a neuroprogressive course of schizophrenia (SZ). On the other hand, it is unclear if such memory dysfunction in schizophrenia could not only be associated with illness progression, but also with neurodevelopment markers such as premorbid crystallized intellectual functioning (IQ). Therefore, we aimed to better understand the relationship between years of illness (YOI), IQ and episodic verbal memory in individuals with SZ.

Methods

We included 218 individuals with confirmed diagnosis of SZ from 3 separate centers (Hospital de Clínicas de Porto Alegre, Brazil; Hospital de Clínicas da Universidade Federal do Paraná, Brazil, and Hospital Clínic de Barcelona, Spain). All participants were informed about study procedures and signed consent before assessment. Participants underwent cognitive assessment with Hopkins Verbal Learning Test (HVLT) for episodic memory and Wechsler Abbreviated Scale of Intelligence for estimated crystallized premorbid IQ. We conducted a mediational analysis to estimate the effect sizes of years of illness in predicting memory deficits considering the indirect effect of IQ as a mediator, as well as age and sex as covariates.

Results

There was a significant indirect effect of years of illness on HVLT immediate recall through IQ, ab=-.119 CI 95% [-.248, -.013]. The mediator could account for more than a third of the total effect, PM=.39. The direct effect of years of illness on immediate recall was only a trend (c: -.09, p= .068), while the total effect counting IQ was significant (c’=-.15, p=.007).

Discussion

The effect sizes of IQ were greater than the direct effect of years of illness on memory deficits in our sample. This finding implicates that neurodevelopment markers such as IQ may be as important as disease progression itself in predicting cognitive outcomes in SZ. While patients with lower premorbid IQ appears to be more prone to memory deficits, those with better early intellectual development appears to count on a protective effect. Neuroprogression in schizophrenia would be an addition of neurodevelopment and disease progression. These results help to give new lights on the heterogeneity in the course of schizophrenia, different trajectories and the need of more personalized approach. Further prospective studies are mandatory.
M127. BODY MASS INDEX IN THE MIDDLE-AGED OFFSPRING OF PARENTS WITH SEVERE MENTAL ILLNESS
Authors: Protsenko Maria , Kerkelä Martta , Miettunen Jouko , Auvinen Juha , Järvelin Marjo-Riitta , Jones Peter , Gissler Mika , Veijola Juha
Published: May 2020

Background

The prevalence of obesity is increasing public health problem with significant costs. Elevated risk for obesity is reported in patients with severe mental illness. People with obesity have an increased risk for a number of common medical conditions, including type 2 diabetes, cardiovascular disease, coronary heart disease, dyslipidemia and hypertension. The increased physical illness may be associated with unhealthy lifestyles such as smoking, substance use, often with inadequate access to health services. Still, very is known about the comorbidity of SMI and obesity in families. We explored the association between parental severe mental illness and BMI in middle-aged offspring. Our hypothesis was that offspring of people with severe mental illness have increased risk for obesity.

Methods

The Northern Finland Birth Cohort 1966 is cohort study of offspring with expected date of birth in 1966. The final study sample included 5,467 middle-aged offspring. We used parental severe mental illness as exposure in the study. BMI measured.at the age of 46 years was classified in for categories: underweight (BMI below 18.5), normal range (BMI 18.5–24.9), overweight (BMI 25.0–29.9), obese class I (BMI 30.0–34.9) and obese class II-III (BMI 35 or more). We used mothers’ marital status, smoking, educational level and offspring’ place of birth as confounders.

Results

Risk for obesity was elevated in offspring of mothers with SMI (overweight: adjusted OR 1.81 (1.25–2.63), obese class I: 1.71 (1.08–2.73), obese class II-III: 2.36 (1.35–4.13)). For offspring of fathers with SMI the results were not statistically significant (overweight: adjusted OR 0.94 (0.70–1.26), obese class I: 1.42 (1.00–2.00), obese class II-III: 0.89 (0.51–1.56)).

Discussion

According to our knowledge, this is the first study of BMI in adult offspring of parents with severe mental illness. We found an elevated risk of obesity in the middle-aged offspring of mothers with SMI. The findings support our hypothesis of higher morbidity from obesity in offspring of parents with SMI. We found an elevated risk of substantially increased BMI in the middle-aged offspring of mothers with SMI. However, we did not find elevated risk of increased BMI in the middle-aged offspring of fathers with SMI and when examining the offspring of either parent with SMI. This means that there might be a common familial pathway leading to co-occurrence of obesity and SMI.
M134. MISMATCH NEGATIVITY IS REFLECTIVE OF DISEASE PROGRESSION RATHER THAN SYMPTOMATIC RECOVERY IN FIRST-EPISODE PSYCHOSIS
Authors: Lho Silvia , Kim Minah , Jeong Hwang Wu , Soo Kwon Jun
Published: May 2020

Background

Whether mismatch negativity (MMN) is associated with clinical status or reflects the disease progression in first-episode psychosis (FEP) patients has not been established. We aimed to investigate whether the change in MMN impairment fluctuates with the change in clinical status during 1-year.

Methods

MMN and the clinical status of 25 patients with FEP were measured at baseline and reassessed after 1 year. MMN of 25 matched healthy controls (HCs) were measured at baseline. Repeated-measures analysis of variance (ANOVA) was used to compare MMN at baseline among the groups, and paired t-tests were utilized to compare baseline and 1-year MMN amplitude of FEP. To identify the association between MMN impairment change and symptomatic, cognitive or functional change during 1-year, this study used multiple regression analysis controlling possible confounders.

Results

MMN amplitudes at baseline were significantly attenuated in FEP patients compared to HC. One-year follow-up MMN amplitude decreased significantly at Fz electrode site in FEP group. Also, the change in MMN amplitudes significantly correlated with the worsened TMT-B but did not with the symptomatic or functional recovery.

Discussion

These results suggest that MMN impairment may be more closely related to cognitive deficits reflecting disease progression than the currently apparent symptoms and functional status during the beginning of a psychotic episode. Future studies are needed to elucidate the relationship with the disease pathophysiology of psychosis and MMN.
M135. DEVELOPMENT OF VISUAL SCANPATH PATTERN ANALYSIS BASED ON FACIAL EMOTION PERCEPTION ENHANCEMENT TRAINING PROGRAM IN SCHIZOPHRENIA PATIENTS
Authors: Nam Beomwoo , Kim Yeseul , Rim Noh Soo , Kim Taehyun
Published: May 2020

Background

Facial expression is an important non-verbal way of expressing the person’s emotional state. If the process of perceiving facial features is impaired, the ability to recognize the emotional state of others is degraded, which may make it difficult to maintain interpersonal and social communications. Many studies have reported on the association between deficit of facial emotion perception (FEP) and the social functioning in schizophrenia. Therefore, we developed visual scanpath pattern analysis based FEP enhancement training program in schizophrenia.

Methods

We enrolled patients visited and admitted Gongju National Hospital and those lived in shared housing facilities for rehabilitation from Sep 2018 to May 2019. 128 patients attended to FEP training program as open, blind and randomized-controlled cross-over design. Both FEP training and mock programs were provided twice a week for a month treatment period with a 4-week washout period between treatment periods. Primary outcome was results of heatmaps based on visual scanpath patterns.

Results

Among 128 patients, 121 completed the study and 7 was dropped out. In FEP training group, their visual scanpath pattern somewhat closer to normal than mock group. When they had an efforts to perceive the emotion of face pictures, FEP training group tended to scan the face pictures more broadly including eye rims, middle of forehead and sided of the mouth in addition to eyes, nose and mouth whereas mock group tended to gaze eyes, nose and mouth intensively.

Discussion

This FEP training program may improve the ability to integrate facial expression cues through visual scanpath pattern changes in schizophrenia patients.

Acknowledgement: This work was supported by the National Research Foundation of Korea (NRF) (Grant number NRF-2016R1E1A2A01953732 & 2018R1E1A2A02059043).
M137. HIGH CONFIDENCE FOR VISUOMOTOR ACTION RECRUITS THE VENTRAL STRIATUM – A METACOGNITIVE APPROACH FOR UNDERSTANDING NEGATIVE SYMPTOMS?
Authors: Bègue Indrit , Pereira Michael , Cojan Yann , Kaiser Stefan , Vuilleumier Patrik
Published: May 2020

Background

Metacognition refers to the ability to discriminate between one’s own correct and incorrect decisions, thus representing a key function for goal-oriented behavior. The neurobiological underpinnings of metacognition have mainly been studied in perceptual decision-making and memory-related processes; therefore, mechanisms and neural correlates underlying metacognitive processes during visuomotor actions are still poorly characterized and the specific role of confidence remains to be elucidated. This is of particular interest as deficits in goal-directed behavior and insight both are a hallmark of the negative symptoms of schizophrenia.

Methods

We examined 31 healthy controls who were asked to draw straight reaching trajectories towards a visual target, while measuring their brain activity with functional Magnetic Resonance Imaging (fMRI). Deviations were introduced in 70% of the trajectories seen on the screen. Participants then reported awareness of deviations (first-order), followed by (second-order) confidence in their response. The amount of deviation was titrated to reach a 71% average detection rate using an adaptive staircase procedure. Metacognition was measured using the M-Ratio, which estimates the ratio of first-order information available for confidence computation (Maniscalco & Lau, 2012). Whole brain activity was analyzed via a parametric general linear model (GLM).

Results

Participants showed good metacognitive abilities at evaluating the correctness of their first-order responses (M-Ratio: 0.98±0.25). Movements were decomposed into two phases based on peaks in the variance of the trajectory deviation and actual joystick position. We found that confidence ratings after deviated trials were explained by a combination of the trajectory deviation in the initial phase (p=0.006; linear mixed model) and the amount of motor correction in the final phase of the movement (p<0.001). At the neural level, as expected, conscious detection of deviation engages strongly the visual cortex, whereas higher visuomotor corrections engage primarily the primary motor cortex. Importantly, we show that high confidence specifically recruits the ventral striatum bilaterally (p<0.05 corrected for multiple comparisons), suggesting a role for confidence in motivating action.

Discussion

Taken together, these results show for the first time in healthy controls that confidence for visuomotor action strongly engages motivational regions in line with a key role of metacognition in goal directed behavior and accurate insight into self-performed actions. These results in healthy controls are currently being tested in a cohort of schizophrenia patients and our hypothesis is that patients with higher level of apathy will display lower metacognitive confidence and lower ventral striatum activity
M142. INCREASED VENTRAL STRIATAL FUNCTIONAL CONNECTIVITY IN PATIENTS WITH SCHIZOPHRENIA DURING REWARD ANTICIPATION
Authors: Carruzzo Fabien , Kirschner Matthias , Kaiser Stefan
Published: May 2020

Background

Recent studies have pointed at the ventral striatum as one of the main candidates underlying motivational dysfunctions in schizophrenia. Patients with negative symptoms show decreased BOLD activity in the ventral striatum and this activity strongly correlates with apathy scores during reward anticipation.

While in patients with schizophrenia blunted ventral striatal activation during reward anticipation has been widely reported, little is known about abnormal striatal functional connectivity during reward anticipation. In this study, we performed generalized whole-brain psychophysiological interaction (gPPI) analyses using the right and left ventral striatum as seeds in schizophrenia patients with apathy and reduced ventral striatal activation from two published fMRI studies (Kirschner et al., 2016; Stepien et al., 2018).

Methods

Forty-four healthy controls (18 females, mean age = 31.1) and 40 patients with schizophrenia (10 females, mean age = 32.5) performed a variant of the Monetary Incentive Delay task within an fMRI design. Negative symptoms were assessed with the Brief Negative Symptoms Scale (BNSS). GPPI analyses were done using the PPPI toolbox on SPM 8. To examine potential difference in striatal functional connectivity, we performed two sample t-tests between patients with schizophrenia and healthy controls using the contrast [High Reward Anticipation – No Reward Anticipation].

Results

Patients with schizophrenia showed increased functional connectivity between the right ventral striatum and the anterior cingulate cortex, posterior cingulate cortex, cerebellum, motor cortex, parietal cortex, temporo-parietal junction and thalamus compared to controls (cluster-level FDR p<0.05). No higher connectivity was found in controls compared to patients.

For the regions with increased functional connectivity, we performed correlations between the patients’ gPPI signal and apathy. We found significant correlations between apathy and functional connectivity between the right ventral striatum and the right posterior cingulate cortex (r=0.40, p<.05) and right parietal cortex (r=0.39, p<.05).

Discussion

Our preliminary results indicate that physiological changes in the ventral striatum lead to dysfunctional connectivity with a cortex-wide network, affecting both cortico-striatal-thalamic-cortical and cortico-striatal-thalamic-cerebellar pathways. In addition, we show that some of these changes are related to apathy levels. This work provides novel insights in cortico-striatal network dysfunction during reward processing in patients with schizophrenia.
M151. DIFFERENCES IN PATTERN OF OBESITY BETWEEN PEOPLE WITH SCHIZOPHRENIA LIVING IN CHINA AND IN AUSTRALIA
Authors: Galletly Cherrie , Wu Xiaoli , Han Zili , Liu Dennis
Published: May 2020

Background

People with psychotic disorders, including schizophrenia, suffer premature cardiovascular morbidity and mortality. Obesity is a major factor in cardiometabolic disorders in this population. There has been very little research investigating differences in patterns of obesity in diverse ethnic populations. Guidelines for treatment of complex comorbidities in people with schizophrenia and related psychoses may need to provide specific recomendations for different ethnic groups.

Methods

The Chinese sample consisted 192 subjects were recruited from the outpatients and inpatients department of the psychiatry department of the third affiliated hospital of Sun Yat-sen. All enrolled subjects were Chinese Han ethnicity, aged 16–45 years, with a diagnosis of schizophrenia according to ICD-10 criteria for schizophrenia, excluding other acute psychiatric disorders. The Australian sample (N=1825) were drawn from the Survey of High Impact Psychosis.

BMI and central obesity were measured in all subjects.

Results

10.3% of men and 4.7% of women in the China sample were obese (BMI>30). In the Australian sample, 41.6% of men and 50.3% of women were obese. Overall, 7.8% of Chinese sample and 45.1% of the Australian sample were obese.

However, amongst the non-obese China sample, 41.7% of men and 53.1% of women had central obesity; the mean for all non-obese Chinese people was 46.7%. 73% of non-obese Australian men and 81.5% of non-obese Australian women had central obesity; the mean for all non-obese Australians was 76%.

Discussion

Chinese Han people with schizophrenia have much lower rates of obesity than the Australian sample. In both groups, rates of abdominal obesity were higher than rates of obesity as defined by BMI. These ethnic differences may help in understanding the high rates of cardiometabolic disorder in people with psychotic disorders in Western countries. They may also inform interventions to assist Western people with psychoses to maintain better physical health.
M168. CLINICAL-ANATOMICAL PHENOTYPES OF SCHIZOPHRENIA
Authors: Kirschner Matthias , Shafiei Golia , Markello Ross D , Markowsky Carolina , Talpalaru Alexandra , Hodzic-Santor Benazir , Devenyi Gabriel A , Lepage Martin , Chakravarty M Mallar , Dagher Alain , Misic Bratislav
Published: May 2020

Background

Although widespread structural brain abnormalities have been consistently reported in schizophrenia, their relation to the heterogeneous clinical manifestations is not well understood. Multivariate methods are needed to uncover covariance patterns between multiple symptom dimensions and system-wide brain imaging data.

Methods

This cross-sectional study used structural magnetic resonance imaging and neuropsychological data from 133 patients with chronic schizophrenia (48 female, 34.8±13.2 years) from the Northwestern University Schizophrenia Data and Software Tool (NUSDAST). We estimate disease-related voxel-wise tissue volume loss using deformation-based morphometry (DBM) of T1 weighted images. In patients with schizophrenia, multiple clinical dimensions including positive/negative symptoms and cognitive deficits, demographic data as well as individual tissue volume loss (DBM) were included in the multivariate model. Clinical-anatomical phenotypes were identified using partial least squares analysis.

Results

Multivariate analysis revealed three distinct clinical-anatomical phenotypes accounting for 27.5%, 15%, and 13% of the shared covariance between clinical-behavioural data and tissue volume loss (total of 55.5%). The first clinical-anatomical phenotype encompassed cognitive impairments, severity of negative symptoms and tissue volume loss within the default mode network and visual network. The second clinical-anatomical phenotype was associated with additional cognitive impairments and tissue volume loss within the frontoparietal and ventral attention network, while the third clinical-anatomical phenotype encompassed a mixed positive and negative symptoms phenotype and tissue volume loss within the dorsal attention network. Critically, the pattern of volume loss within the first most prevalent clinical-anatomical phenotype mediated (a*b) the effect of socioeconomic status on clinical outcome (cognitive performance and negative symptoms) (a*b=-0.033(0.008); P<1.0×〖10〗^(-4); 95% CI [-0.049, -0.018]). Finally, we partly replicated the first clinical-anatomical phenotype in an independent sample of patients with schizophrenia (n=108).

Discussion

The heterogeneous clinical manifestation of schizophrenia can be significantly explained by three clinical-anatomical phenotypes. Despite their distributed topography, each phenotype is centered on a specific, well-defined set of intrinsic networks.
M176. INTESTINAL PERMEABILITY AND LOW-GRADE CHRONIC INFLAMMATION IN SCHIZOPHRENIA: DO THEY INFLUENCE COGNITION AND COGNITIVE RESERVE?
Authors: Anmella Gerard , Amoretti Silvia , Alfonso Miqueu , Cuñat Oriol , Safont Gemma , Pérez Ferran , Garcia-Portilla ,M Paz , De la Fuente Laura , Bernardo Arroyo Miguel , Arranz Belen
Published: May 2020

Background

Higher intestinal-permeability is known to cause low-grade chronic inflammation, which seems to participate in the development and worsening of psychotic disorders both in first-episode psychosis (FEP) and schizophrenia (SCZ) patients. Moreover, in psychotic disorders, inflammation has been linked to cognition and cognitive reserve (CR).

The aim of this study is to assess the relation between intestinal-permeability, low-grade chronic inflammation, cognition and cognitive reserve in psychotic disorders.

Methods

Observational, cross-sectional and multisite study including four centers in Spain (Grant from Fondo de Investigación Sanitaria, PI17/00246). A total of 500 adult patients with DSM-5 SCZ-spectrum disorder at any stage of the disease were recruited.

Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Disease severity was assessed using the Clinical Global Impression (CGI) scale and functioning was assessed using the Global Assessment of Functioning (GAF) scale. The intestinal-permeability was estimated with the “Permeable-Intestine-syndrome questionnaire”. The diet was assessed with the “Mediterranean-diet-adherence questionnaire”. Exercise was measured with the “International Physical Activity Questionnaire (IPAQ)”. Cognition was measured with the SCIP-S scale. CR was assessed with the Cognitive Reserve Assessment Scale in Health (CRASH), which is a scale developed to measure CR specifically for patients with severe mental illness.

Correlations between CRASH scores and the remainder variables were performed.

Results

For the present study we included only the subjects who had CRASH score, a total of 112 patients, 42.7% female, aged 40.61±12.4 (mean±SD). Substance use was present in 44.3%.

The CRASH score was 33.30±15.72 (mean±SD) and was associated with negative (but not positive) psychotic symptoms assessed by PANSS (PANSS negative; rp=-3.98; p=0.001, PANSS general; rp=-2.13; p=0.038, GAF; rp=0.410; p<0.0001, CGI; rp=-0.30; p=0.002, IPAQ; rs=0.224; p=0.025 and the permeability-scale; rs=-0.266; p=0.008.

All cognitive domains (assessed by SCIP-S) were associated to CRASH: verbal learning immediate (rp=0.584; p<0.0001) and differed (rp=0.515; p<0.0001), working memory (rp=0.539; p<0.0001), verbal fluency (rs=0.485; p<0.0001) and processing speed (rp=0.584; p<0.0001).

No significant associations were found with Mediterranean-diet scale (rs=0.195; p=0.056), IMC (rs=-0.192; p=0.063), C-reactive protein (rs=-0.104; p=0.278) and the IPAQ-resting scale and permeability-scale (rs=0.119; p=0.244).

Discussion
M193. CHANGES IN THEORY OF MIND DETECTED IN SCHIZOPHRENIA SPECTRUM DISORDERS- A LITERATURE REVIEW
Authors: Vasiliu Octavian
Published: May 2020

Background

Theory of mind (ToM) is a core feature of the social functioning because it influences the way an individual perceive other people’s mental states, and because responses to social cues are shaped by one’s ToM. Patients diagnosed with schizophrenia spectrum disorders (SSD) often present cognitive symptoms as part of their clinical manifestations, and there is a controversy about the relation of ToM deficiencies and more general cognitive features of schizophrenia and related disorders [1]. In order to find data that may clarify if ToM deficiencies are part of the schizophrenia cognitive dimension, or if they precede the onset of psychosis and simply coexist with other symptoms met in this type of disorders, a literature analysis was conducted.

Methods

This review included papers published between January 2000 and August 2019 in the main electronic databases (PubMed, Cochrane, EMBASE, CINAHL). Keywords used for database search were “schizophrenia spectrum disorders”, “schizophrenia”, “schizoaffective disorder”, “delusional disorder”, or “schizophreniform disorder” and “theory of mind”. There was included no age limit, and no exclusion criteria referred to the duration of the disorder.

Results

A number of 93 papers resulted after the primary search, but only 17 remained after de-duplication and application of inclusion/exclusion criteria. A study with young adults diagnosed with first episode of schizophrenia and matched controls (n=128) suggested that ToM deficits are partly independent of other cognitive functions [1]. Another study (n=1630 children 11–12 years old) reported specific alterations in ToM may be associated with specific types of psychotic experiences, and exaggerated type of ToM may index risk for developing psychosis and paranoid delusions in particular [2]. Adolescents who were genetically at high risk for schizophrenia had social skills impairments but no ToM deficits in a study [3]. Also, there is evidence for ToM deficits in the healthy relatives of schizophrenics, patients with delusional disorder, and individual with high schizotypy scores [4]. The hyper-connectivity in SSD has been confirmed on functional magnetic resonance imaging and default connectivity is correlated to and predictive of theory of mind performance [5]. A significant number of papers (n=10) did not formulate any clear argument to support the independent versus secondary status of the ToM deficits in relation to the SSD cognitive dimension.

Discussion

ToM deficiencies are important elements that have been associated with the social skills and functioning in patients with SSD, although it is not clear if these elements exist independently from other cognitive symptoms. Relatives of patients with SSD may present ToM deficits, and data exist about the correlation between ToM abnormalities and several positive symptoms of the SSD. However, more well designed trials are needed in order to confirm the association between ToM impairments and SSD.

References