Bob Oranje

Unique developmental trajectories of cortical thickness and surface area

There is evidence that the timing of developmental changes in cortical volume and thickness varies across the brain, although the processes behind these differences are not well understood. In contrast to volume and thickness, the regional developmental trajectories of cortical surface area have not yet been described. The present study used a combined cross-sectional and longitudinal design with 201 MRI-scans (acquired at 1.5-T) from 135 typically developing children and adolescents. Scans were processed using FreeSurfer software and the Desikan-Killiany atlas. Developmental trajectories were estimated using mixed model regression analysis. Within most regions, cortical thickness showed linear decreases with age, whereas both cortical volume and surface area showed curvilinear trajectories. On average, maximum surface area occurred later in development than maximum volume. Global gender differences were more pronounced in cortical volume and surface area than in average thickness. Our findings suggest that developmental trajectories of surface area and thickness differ across the brain, both in their pattern and their timing, and that they also differ from the developmental trajectory of global cortical volume. Taken together, these findings indicate that the development of surface area and thickness is driven by different processes, at least in part.

The effects of a sub-anaesthetic dose of ketamine on human selective attention

A growing number of studies demonstrate that antagonists of the N-methyl-D-aspartate (NMDA) receptors can induce a broad range of psychophysiological anomalies in healthy subjects similar to those observed in schizophrenia. In this study, the effect of a sub-anaesthetic dose of the non-competitive NMDA antagonist, ketamine, on human selective attention was explored. It was hypothesized that ketamine would induce in healthy subjects psychophysiological anomalies that are commonly observed in schizophrenic patients, such as reduced P300 amplitude and a reduction of both mismatch negativity (MMN) and processing negativity (PN). In a double-blind randomized placebo-controlled design, healthy male volunteers (n = 18) were challenged with a sub-anaesthetic dose of ketamine (0.3 mg/kg iv) after which they were tested in a selective attention task. In this task, two types of stimuli were evenly presented to the left or right ear: standard tones (80%) and deviant tones (20%) of either 1000 or 1100 Hz. The duration of a stimulus (95 dB) was 50 ms, the interstimulus intervals were randomized between 1750 and 2150 ms. The volunteer was instructed to push a button as quickly as possible after hearing the deviant tone in a specified ear. Ketamine did not alter performance of the subjects: in both the placebo and drug condition their reaction times for and percentages of hits and false alarms did not differ. Ketamine did, however, reduce PN and the P300 amplitude (both in general and to deviant stimuli in particular). However, no drug effect on MMN was found. In addition, ketamine enhanced the N100 amplitude to deviant stimuli. In conclusion, ketamine induces some of the attentional deficits in healthy controls that are observed in schizophrenic patients. Consequently, reduced glutamatergic activity in the brain may be involved in some of the symptoms of schizophrenia.

The effects of low dose ketamine on sensory gating, neuroendocrine secretion and behavior in healthy human subjects

Abstract Recently, much interest has been given to the role of glutamatergic N-methyl-D-aspartate receptors (NMDA) in sensory gating, such as prepulse inhibition (PPI) and reduction of the P50 evoked response potential (ERP). Currently, mainly animal data are available describing the role of NMDA receptors in these stimulus evaluation processes. Human data are virtually lacking and are potentially important, for instance for the understanding of sensory gating deficits observed in schizophrenia. Therefore, the effects of the NMDA antagonist ketamine, in a dose of 0.3 mg/kg IV, on concurrent assessment of PPI and P50 reduction was studied in 18 healthy male volunteers. Ketamine was administered in a pseudo-steady state model with a subacute loading dose. In addition, the effects of ketamine on behavior, vital signs, homovanillic acid (HVA) plasma levels and secretion of cortisol and luteinizing hormone (LH) were also determined. Ketamine did not significantly alter PPI or the reduction of the P50 ERP. A small but significant increase in Brief Psychiatric Rating Scale (BPRS) total scores and BPRS composite scores “thinking disorder” and “withdrawal/retardation” was observed. Several subjects experienced visual perceptional alterations, but complex hallucinations did not occur. Ketamine induced mild analgesia and coordination problems. In addition, ketamine induced a marked rise in cortisol secretion, while LH secretion was not affected. Finally, systolic and diastolic, blood pressure and heart rate increased during ketamine infusion. Although in humans NMDA receptors may not be involved in the regulation of PPI and P50 reduction, the most likely explanation for the lack of effect of ketamine on these sensory gating paradigms is the dose used in this experiment. However, using a higher dose is hampered by the aspecificity of racemic ketamine. Future studies should use the enantiomer S-ketamine, which is more specific to NMDA receptors, to evaluate the involvement of NMDA receptors in these neurophysiological processes further.

Effects of typical and atypical antipsychotics on the prepulse inhibition of the startle reflex in patients with schizophrenia.

Patients with schizophrenia show a loss of sensory (motor) gating, which is reflected in a reduced prepulse inhibition (PPI) of the startle reflex. Furthermore, patients with schizophrenia habituate less than healthy subjects. From previous studies, it is clear that typical antipsychotics have little or no effect on either sensorimotor gating or habituation, while only limited data is available on the effects of atypical antipsychotics on these processes. Forty-four schizophrenic patients (27 stable on typical and 17 stable on atypical antipsychotics) and 35 healthy control subjects were tested in a PPI paradigm. The prepulse and startle stimuli were pure tones of 1500 Hz (duration 40ms, intensity 80 dB and 110 dB respectively), with a fixed interstimulus interval of 120 milliseconds. Block effects in PPI and startle amplitude to the pulse alone trials (habituation) were analyzed over the three groups, using comedication (i.e., benzodiazepines) as a covariate. Main effect for block was found for startle amplitude (habituation), while main effects for group and block were found for percentage PPI. Further analysis displayed significant differences in PPI between the patients treated with typical antipsychotics and the healthy control group, while patients treated with atypical antipsychotics did not differ from either the healthy control group, or the patients treated with typical antipsychotics. Furthermore, post-hoc division of the patients treated with atypical antipsychotics in patients treated with clozapine and risperidone revealed that this superiority from atypical antipsychotics over typical antipsychotics appeared to be mainly based on the effects of clozapine. Patients with schizophrenia who are treated with atypical antipsychotics appear to have levels of sensorimotor gating that are more consistent with healthy controls than patients who are treated with typical antipsychotics. Furthermore, within the class of atypical antipsychotics, clozapine appears most potent in restoring this process.

Typical development of basal ganglia, hippocampus, amygdala and cerebellum from age 7 to 24

Developmental imaging studies show that cortical grey matter decreases in volume during childhood and adolescence. However, considerably less research has addressed the development of subcortical regions (caudate, putamen, pallidum, accumbens, thalamus, amygdala, hippocampus and the cerebellar cortex), in particular not in longitudinal designs. We used the automatic labeling procedure in FreeSurfer to estimate the developmental trajectories of the volume of these subcortical structures in 147 participants (age 7.0-24.3years old, 94 males; 53 females) of whom 53 participants were scanned twice or more. A total of 223 magnetic resonance imaging (MRI) scans (acquired at 1.5-T) were analyzed. Substantial diversity in the developmental trajectories was observed between the different subcortical gray matter structures: the volume of caudate, putamen and nucleus accumbens decreased with age, whereas the volume of hippocampus, amygdala, pallidum and cerebellum showed an inverted U-shaped developmental trajectory. The thalamus showed an initial small increase in volume followed by a slight decrease. All structures had a larger volume in males than females over the whole age range, except for the cerebellum that had a sexually dimorphic developmental trajectory. Thus, subcortical structures appear to not yet be fully developed in childhood, similar to the cerebral cortex, and continue to show maturational changes into adolescence. In addition, there is substantial heterogeneity between the developmental trajectories of these structures.

Prepulse inhibition and P50 suppression: Commonalities and dissociations

Patients with schizophrenia exhibit reduced levels of both prepulse inhibition of the startle reflex (PPI) and condition-test suppression of the P50 event-related potential. This study investigated the extent to which PPI and P50 suppression, which exhibit similar parametric sensitivities, are intrinsically auditory phenomena or can be induced cross-modally, and reflect common or distinct neural mechanisms of inhibition. PPI, N100, and P50 were assessed in 20 healthy male volunteers, using auditory test probes and both visual and auditory lead stimuli, separated by 100- or 500-ms interstimulus intervals (ISIs). PPI was found in the auditory-lead condition across the complete group, and with visual-lead stimuli in approximately half of the subjects. Intra-modal auditory PPI was significantly higher with the 100-ms ISI than with the 500-ms ISI. P50 suppression was found only with the 500-ms ISI, with no difference between the auditory and visual conditions. Source analyses revealed that suppression was associated with frontal cortical activity. N100 suppression was found only in the auditory condition, with no difference between 100- and 500-ms ISIs. Although both phenomena are considered to provide operational measures of gating, PPI and P50 suppression are differentially sensitive to ISI and therefore reflect partly different neural mechanisms. They are not intrinsically auditory phenomena, and both appear to involve frontal cortical activity. In contrast, N100 suppression is most likely based on refractory mechanisms intrinsic to the auditory system.

Decreased Frontal Serotonin2A Receptor Binding in Antipsychotic-Naive Patients With First-Episode Schizophrenia

CONTEXT Postmortem investigations and the receptor affinity profile of atypical antipsychotics have implicated the participation of serotonin(2A) receptors in the pathophysiology of schizophrenia. Most postmortem studies point toward lower cortical serotonin(2A) binding in schizophrenic patients. However, in vivo studies of serotonin(2A) binding report conflicting results, presumably because sample sizes have been small or because schizophrenic patients who were not antipsychotic-naive were included. Furthermore, the relationships between serotonin(2A) binding, psychopathology, and central neurocognitive deficits in schizophrenia are unclear. OBJECTIVES To assess in vivo brain serotonin(2A) binding potentials in a large sample of antipsychotic-naive schizophrenic patients and matched healthy controls, and to examine possible associations with psychopathology, memory, attention, and executive functions. DESIGN Case-control study. SETTING University hospital, Denmark. PARTICIPANTS A sample of 30 first-episode, antipsychotic-naive schizophrenic patients, 23 males and 7 females, and 30 matched healthy control subjects. INTERVENTIONS Positron emission tomography with the serotonin(2A)-specific radioligand fluorine 18-labeled altanserin and administration of a neuropsychological test battery. MAIN OUTCOME MEASURES Binding potential of specific tracer binding, scores on the Positive and Negative Syndrome Scale, and results of neuropsychological testing. RESULTS Schizophrenic patients had significantly lower serotonin(2A) binding in the frontal cortex than did control subjects. A significant negative correlation was observed between frontal cortical serotonin(2A) binding and positive psychotic symptoms in the male patients. No correlations were found between cognitive functions and serotonin(2A) binding. CONCLUSION The results suggest that frontal cortical serotonin(2A) receptors are involved in the pathophysiology of schizophrenia. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00207064.

Modulating sensory gating in healthy volunteers: the effects of ketamine and haloperidol.

Abstract Background Antagonists of the N-methyl-D-aspartate (NMDA) receptors induce a broad range of psychophysiologic symptoms in healthy subjects that are similar to those of schizophrenia, such as disturbances in the sensory gating of stimuli. Because antipsychotics reduce symptoms in schizophrenia, they may also reduce the effects of NMDA antagonists. Methods In our study, a group of 18 healthy male volunteers was tested in prepulse inhibition (PPI) and P50 evoked potential paradigms during placebo–placebo, placebo–ketamine (.3 mg/kg; intravenous), and 2-mg haloperidol/.3 mg/kg intravenous ketamine conditions. Results Suppression of PPI and P50 in the ketamine condition did not differ from either the placebo–placebo or the haloperidol–ketamine condition; however, a significant reduction in percentage PPI to the lowest prepulse intensity and a reduction of P50 suppression were found in the haloperidol–ketamine condition. Conclusions The combination of haloperidol and ketamine was found to disrupt P50 suppression and PPI in healthy male volunteers, whereas ketamine alone did not affect either measure. This may imply that the disrupted P50 suppression and PPI found in schizophrenia is related to reduced dopaminergic activity, most likely in the prefrontal cortex.

P50 suppression and prepulse inhibition of the startle reflex in humans: a correlational study.

BACKGROUND Sensory gating is an important feature of the normally functioning brain. When not operating correctly, it can contribute to different kinds of psychiatric illnesses by flooding the higher brain functions with useless information. Over the years, two paradigms have evolved to quantify the amount of sensory gating: the prepulse inhibition (PPI) of the startle reflex and the suppression of the P50 evoked potential. To enable comparison across studies it is important to find out to what extent these paradigms reflect the same processes. In the present study, this relationship was explored. METHODS Thirty-one healthy male volunteers with no personal or family history of mental illness were tested on their ability to suppress the P50 wave and to inhibit the startle reflex. RESULTS A significant positive correlation was found between PPI and P50 suppression mainly early in testing, when habituation of the startle reflex is taking place. Furthermore, a significant negative correlation was found between P50 suppression in the second half of testing and the habituation of the startle reflex. CONCLUSIONS PPI and P50 suppression are correlated at an early stage of testing, when the process of habituation of the startle reflex is active. The role of the habituation in the correlation between these two measures needs to be further explored.

Schizophrenia: From the brain to peripheral markers. A consensus paper of the WFSBP task force on biological markers

Objective. The phenotypic complexity, together with the multifarious nature of the so-called “schizophrenic psychoses”, limits our ability to form a simple and logical biologically based hypothesis for the disease group. Biological markers are defined as biochemical, physiological or anatomical traits that are specific to particular conditions. An important aim of biomarker discovery is the detection of disease correlates that can be used as diagnostic tools. Method. A selective review of the WFSBP Task Force on Biological Markers in schizophrenia is provided from the central nervous system to phenotypes, functional brain systems, chromosomal loci with potential genetic markers to the peripheral systems. Results. A number of biological measures have been proposed to be correlated with schizophrenia. At present, not a single biological trait in schizophrenia is available which achieves sufficient specificity, selectivity and is based on causal pathology and predictive validity to be recommended as diagnostic marker. Conclusions. With the emergence of new technologies and rigorous phenotypic subclassification the identification of genetic bases and assessment of dynamic disease related alterations will hopefully come to a new stage in the complex field of psychiatric research.