Elsa Y. Costanzo

Emotion processing and theory of mind in schizophrenia patients and their unaffected first-degree relatives

Previous studies have suggested that social cognition is affected in individuals with schizophrenia. The purpose of this study was to explore to what extent social cognition deficits are shared by unaffected first-degree relatives, and the nature of the relationship between performance in different paradigms of social cognition. 20 Schizophrenia patients (7 females, 31+/-10 years), 20 healthy age- and gender-matched individuals, 20 unaffected first-degree relatives of the schizophrenia patients (11 females, 50+/-20 years), and 20 healthy individuals matched for age and gender were recruited. Patients showed deficits in the detection of social Faux Pas (0.80+/-0.17 vs. controls: 0.94+/-0.09, p=0.025) and the correct identification of Theory of Mind stories (0.71+/-0.13 vs. controls: 0.82+/-0.12, p=0.038). Relatives performed poorly in the Faces Test (0.83+/-0.14 vs. controls: 0.9+/-0.08, p=0.048), the Reading the Mind in the Eyes Test (0.59+/-0.17 vs. controls: 0.71+/-0.14, p=0.046) and the detection of social Faux Pas (0.8+/-0.2 vs. controls: 0.93+/-0.09, p=0.024). Abnormalities were independent of age, years of education, and general cognitive performance in patients and their relatives. Performance in an Emotion Processing task (Faces Test) was correlated with performance in theory of mind tests in healthy individuals and relatives of patients with schizophrenia only. These results suggest that schizophrenia patients and their unaffected first-degree relatives display similar but nonidentical patterns of social cognition processing.

Decreased activity in right-hemisphere structures involved in social cognition in siblings discordant for schizophrenia

BACKGROUND Social cognitive deficits contribute to functional disability in schizophrenia. Social cognitive tasks in healthy persons consistently evoke activation of medial prefrontal cortex, inferior frontal gyrus, temporoparietal gyrus, and posterior cingulate cortex/precuneus. We tested the hypothesis that patients with schizophrenia and their unaffected siblings share dysfunction of the same neural networks. METHODS Neural activation during emotion processing (EP), theory of mind (ToM), and control tasks was measured using functional magnetic resonance imaging (fMRI) in 14 patients with schizophrenia, 14 nonpsychotic siblings of patients with schizophrenia, and 14 matched healthy subjects. RESULTS Compared with healthy controls, patients with schizophrenia showed reduced activation of right hemisphere structures involved in EP and ToM including inferior frontal gyrus, middle frontal gyrus, and right temporoparietal junction. These deficits were shared, in part, by unaffected siblings. The latter group demonstrated deficits in bilateral precuneus activation during ToM, not present in patients. CONCLUSIONS Schizophrenia appears to be associated with a deficit in activation of right hemisphere components of a ToM network. Such deficits are shared in part by those at high genetic risk but unaffected by schizophrenia.

Olfactory Dysfunction Evaluation Is Not Affected by Comorbid Depression in Parkinson's Disease.

Olfactory function assessment is an important screening tool for Parkinsons disease (PD) diagnosis. It is debated whether olfaction is affected by comorbid depression. We assessed the relationship between depression and olfaction in PD and determined whether depression may limit the usefulness of olfactory testing for PD diagnosis.

Brain activation induced by psychological stress in patients with schizophrenia

Environmental influences are critical for the expression of genes putatively related to the behavioral and cognitive phenotypes of schizophrenia. Among such factors, psychosocial stress has been proposed to play a major role in the expression of symptoms. However, it is unsettled how stress interacts with pathophysiological pathways to produce the disease. We studied 21 patients with schizophrenia and 21 healthy controls aged 18 to 50years with 3T-fMRI, in which a period of 6min of resting state acquisition was followed by a block design, with three blocks of 1-min control-task, 1-min stress-task and 1-min rest after-task. Self-report of stress and PANSS were measured. Limbic structures were activated in schizophrenia patients by simple tasks and remained active during, and shortly after stress. In controls, stress-related brain activation was more time-focused, and restricted to the stressful task itself. Negative symptom severity was inversely related to activation of anterior cingulum and orbitofrontal cortex. Results might represent the neurobiological aspect of hyper-reactivity to normal stressful situations previously described in schizophrenia, thus providing evidence on the involvement of limbic areas in the response to stress in schizophrenia. Patients present a pattern of persistent limbic activation probably contributing to hypervigilance and subsequent psychotic thought distortions.

Mood, Th-1/Th-2 cytokine profile, and autonomic activity in older adults with acute/decompensated heart failure: preliminary observations.

In order to assess the relationships among mood, peripheral autonomic output and circulating immunoinflammatory mediators in older individuals with decompensated heart failure (CHF), 20 consecutive patients (78±7 years, 35% women) admitted to the coronary care unit with a clinical diagnosis of acute/decompensated CHF of coronary origin were examined. Mood was evaluated by the 21-item Hamilton Depression Scale (HAM-D). Four patients met the criteria for major depression. Heart rate variability (HRV) analysis and the levels of tumour necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-6 and IL-10 were measured within 24–72 h of admission. A significant positive relationship between score in HAM-D and serum IL-6 levels was detected with a similar trend as far as IL-2 levels. Circulating IL-2 levels were strongly associated with the HRV L/H quotient, an index of increased sympathetic and/or decreased parasympathetic thoracic activity. A negative correlation between vagal activity (as assessed by HRV) and IL-4 occurred. Neither TNF-α nor IL-10 were detectable in this group of elderly patients. The results add to the concept that mood and autonomic unbalance are associated with increased systemic inflammation in old patients with decompensated CHF, a potential mechanism for mood-related worsened prognosis of heart failure at an advanced age.

Cluster B personality symptoms in persons at genetic risk for schizophrenia are associated with social competence and activation of the right temporo-parietal junction during emotion processing

Personality disorders are common in nonpsychotic siblings of patients with schizophrenia, and some personality traits in this group may be associated with an increased risk for full-blown psychosis. We sought to establish if faulty right-hemisphere activation induced by social cognitive tasks, as previously described in patients with schizophrenia, is associated with specific personality symptoms in their unaffected siblings. We observed that cluster B personality symptoms in this group were inversely related to activation in the right temporo parietal junction (rTPJ, a structure critical in social cognitive processing) in response to a basic emotion processing task and also to social competence, whereas in contrast to our initial hypothesis, cluster A traits were not associated with right hemisphere activation during emotion processing or with social competence. These findings suggest the existence of clinical traits in at-risk individuals which share a common neurobiological substrate with schizophrenia, in regards to social performance.

Social Cognition in a Clinical Sample of Personality Disorder Patients.

Social cognition was assessed in a clinical sample of personality disorder (PD) stable patients receiving ambulatory treatment (N = 17) and healthy matched controls (N = 17) using tests of recognition of emotions in faces and eyes, in a test of social faux pas and in theory of mind (ToM) stories. Results indicated that when compared with healthy controls, individuals with PD showed a clear tendency to obtain lower scoring in tasks assessing recognition of emotion in faces (T = −2.602, p = 0.014), eyes (T = −3.593, p = 0.001), ToM stories (T = −4.706, p = 0.000), and Faux pas (T = −2.227, p = 0.035). In the present pilot study, PD individuals with a normal cognitive efficiency showed an impaired performance at social cognition assessment including emotion recognition and ToM.

Hemispheric specialization of mood processing is abnormal in patients with schizophrenia

Abnormalities of brain lateralization are among the most consistent neurobiological signatures of the schizophrenia syndrome (Schweitzer et al., 1978; Hirnstein and Hugdahl, 2014). Most studies have focused on alterations in the lateralization of language, sensory processing,macroscopic brain morphology, and motor dexterity, which have been long known to exhibit hemispheric specialization in H. sapiens (Newcombe and Ratcliff, 1973). In fact, it has been proposed that language and psychosismight share a common origin related to the development of brain lateralization in H. sapiens, presumably when our species diverged from other hominins some160,000 years ago (Crow, 2008). Implicit language functions and social cognition have also been proposed to stem from lateralization deficits (Guinjoan et al., 2015), whichmight bear significant clinical value in schizophrenia as the syndrome presents remarkable disturbances in mood processing and social behavior. Healthy individuals display hemispheric specialization in emotion processing (e.g., Craig, 2009; Costanzo et al., 2015). We hypothesized that development of abnormal brain lateralization in schizophrenia involves emotion processing in addition to language and motor dexterity, and specifically predicted that patients with schizophrenia would display deficits in left hemisphere activation during language tasks and impairments in right hemisphere activation during the induction of sadness, as evidence of an overall deficit in hemispheric specialization in this group. We studied 15 right-handed medicated patients with chronic stable schizophrenia (31± 9 years, 47%women) and 20 right-handed healthy individuals (26 ± 5 years, 55% women) with a functional magnetic resonance imaging paradigm of phonological fluency and sadness induction described in detail elsewhere (Costanzo et al., 2015). Briefly, a block design was employed in a GE Hx 3T for both word generation

2091 – Brain activation in patients with schizophrenia during psychological stress

Introduction It is commonly accepted that in most patients with schizophrenia external factors act on genetic predisposition to produce active psychotic symptoms. It is known that patients with schizophrenia have an abnormal peripheral autonomic response to psychological stress. We sought to characterize the brain activity patterns of such response in these patients. Methods We studied the pattern of brain activation in response to a mental arithmetic stress paradigm in 14 patients and 14 healthy subjects aged 18 to 50 years, using 3T-fMRI. A period of 6 minutes of resting state acquisition were followed by a block design with three 1-minute CONTROL task (one digit sum), 1 minute STRESS task (two digit substraction) and 1 minute rest after task. Data were analyzed with SPM and SPSS software. Results While controls showed bilateral activation of hippocampi, parahippocampi, insulae, amygdalae, anterior cinguli and basal ganglia during mental stress, patients displayed less left hemisphere activation, specifically in insula, orbitofrontal cortex and frontal cortex, along with activation of pons. Moreover, patients did not show activation of hippocampi, parahippocampi and amygdalae. After stress healthy subjects recovered its basal pattern. However, patients showed sustained activation of right posterior cingulum and temporal pole, along with bilateral orbitofrontal cortex, frontal cortex, precuneus, cuneus and angular gyrus for the observation period. Conclusions Present results suggest that abnormal activation of limbic structures underlies extensively documented peripheral autonomic abnormalities in patients with schizophrenia. Abnormal fronto-temporal connectivity may be the pathophysiological link for these results.