Guusje Collin

Abnormal Rich Club Organization and Functional Brain Dynamics in Schizophrenia

IMPORTANCE The human brain forms a large-scale structural network of regions and interregional pathways. Recent studies have reported the existence of a selective set of highly central and interconnected hub regions that may play a crucial role in the brains integrative processes, together forming a central backbone for global brain communication. Abnormal brain connectivity may have a key role in the pathophysiology of schizophrenia. OBJECTIVE To examine the structure of the rich club in schizophrenia and its role in global functional brain dynamics. DESIGN Structural diffusion tensor imaging and resting-state functional magnetic resonance imaging were performed in patients with schizophrenia and matched healthy controls. SETTING Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands. PARTICIPANTS Forty-eight patients and 45 healthy controls participated in the study. An independent replication data set of 41 patients and 51 healthy controls was included to replicate and validate significant findings. MAIN OUTCOME(S) AND MEASURES: Measures of rich club organization, connectivity density of rich club connections and connections linking peripheral regions to brain hubs, measures of global brain network efficiency, and measures of coupling between brain structure and functional dynamics. RESULTS Rich club organization between high-degree hub nodes was significantly affected in patients, together with a reduced density of rich club connections predominantly comprising the white matter pathways that link the midline frontal, parietal, and insular hub regions. This reduction in rich club density was found to be associated with lower levels of global communication capacity, a relationship that was absent for other white matter pathways. In addition, patients had an increase in the strength of structural connectivity-functional connectivity coupling. CONCLUSIONS Our findings provide novel biological evidence that schizophrenia is characterized by a selective disruption of brain connectivity among central hub regions of the brain, potentially leading to reduced communication capacity and altered functional brain dynamics.

Structural and Functional Aspects Relating to Cost and Benefit of Rich Club Organization in the Human Cerebral Cortex

Recent findings have demonstrated that a small set of highly connected brain regions may play a central role in enabling efficient communication between cortical regions, together forming a densely interconnected “rich club.” However, the density and spatial layout of the rich club also suggest that it constitutes a costly feature of brain architecture. Here, combining anatomical T1, diffusion tensor imaging, magnetic transfer imaging, and functional MRI, several aspects of structural and functional connectivity of the brains rich club were examined. Our findings suggest that rich club regions and rich club connections exhibit high levels of wiring volume, high levels of white matter organization, high levels of metabolic energy usage, long maturational trajectories, more variable regional time series, and more inter-regional functional couplings. Taken together, these structural and functional measures extend the notion that rich club organization represents a high-cost feature of brain architecture that puts a significant strain on brain resources. The high cost of the rich club may, however, be offset by significant functional benefits that the rich club confers to the brain network as a whole.

Impaired Rich Club Connectivity in Unaffected Siblings of Schizophrenia Patients

Schizophrenia has been conceptualized as a disorder of brain connectivity. Recent studies suggest that brain connectivity may be disproportionally impaired among the so-called rich club. This small core of densely interconnected hub regions has been hypothesized to form an important infrastructure for global brain communication and integration of information across different systems of the brain. Given the heritable nature of the illness, we hypothesized that connectivity disturbances, including abnormal rich club connectivity, may be related to familial vulnerability for schizophrenia. To test this hypothesis, both schizophrenia patients and unaffected siblings of patients were investigated. Rich club organization was examined in networks derived from diffusion-weighted imaging in 40 schizophrenia patients, 54 unaffected siblings of patients, and 51 healthy control subjects. Connectivity between rich club hubs was differentially reduced across groups (P = .014), such that it was highest in controls, intermediate in siblings (7.9% reduced relative to controls), and lowest in patients (19.6% reduced compared to controls). Furthermore, in patients, lower levels of rich club connectivity were found to be related to longer duration of illness and worse overall functioning. Together, these findings suggest that impaired rich club connectivity is related to familial, possibly reflecting genetic, vulnerability for schizophrenia. Our findings support a central role for abnormal rich club organization in the etiology of schizophrenia.

The Ontogeny of the Human Connectome Development and Dynamic Changes of Brain Connectivity Across the Life Span

The human brain comprises distributed cortical regions that are structurally and functionally connected into a network that is known as the human connectome. Elaborate developmental processes starting in utero herald connectome genesis, with dynamic changes in its architecture continuing throughout life. Connectome changes during development, maturation, and aging may be governed by a set of biological rules or algorithms, forming and shaping the macroscopic architecture of the brain’s wiring network. To explore the presence of developmental patterns indicative of such rules, this review considers insights from studies on the cellular and the systems level into macroscopic connectome genesis and dynamics across the life span. We observe that in parallel with synaptogenesis, macroscopic connectome formation and transformation is characterized by an initial overgrowth and subsequent elimination of cortico-cortical axonal projections. Furthermore, dynamic changes in connectome organization throughout the life span are suggested to follow an inverted U-shaped pattern, with an increasingly integrated topology during development, a plateau lasting for the majority of adulthood and an increasingly localized topology in late life. Elucidating developmental patterns in brain connectivity is crucial for our understanding of the human connectome and how it may give rise to brain function, including the occurrence of brain network disorders across the life span.

Impaired Cerebellar Functional Connectivity in Schizophrenia Patients and Their Healthy Siblings

The long-standing notion of schizophrenia as a disorder of connectivity is supported by emerging evidence from recent neuroimaging studies, suggesting impairments of both structural and functional connectivity in schizophrenia. However, investigations are generally restricted to supratentorial brain regions, thereby excluding the cerebellum. As increasing evidence suggests that the cerebellum contributes to cognitive and affective processing, aberrant connectivity in schizophrenia may include cerebellar dysconnectivity. Moreover, as schizophrenia is highly heritable, unaffected family members of schizophrenia patients may exhibit similar connectivity profiles. The present study applies resting-state functional magnetic resonance imaging to determine cerebellar functional connectivity profiles, and the familial component of cerebellar connectivity profiles, in 62 schizophrenia patients and 67 siblings of schizophrenia patients. Compared to healthy control subjects, schizophrenia patients showed impaired functional connectivity between the cerebellum and several left-sided cerebral regions, including the hippocampus, thalamus, middle cingulate gyrus, triangular part of the inferior frontal gyrus, supplementary motor area, and lingual gyrus (all p < 0.0025, whole-brain significant). Importantly, siblings of schizophrenia patients showed several similarities to patients in cerebellar functional connectivity, suggesting that cerebellar dysconnectivity in schizophrenia might be related to familial factors. In conclusion, our findings suggest that dysconnectivity in schizophrenia involves the cerebellum and that this defect may be related to the risk to develop the illness.

Disrupted functional brain networks in autistic toddlers

Communication and integration of information between brain regions plays a key role in healthy brain function. Conversely, disruption in brain communication may lead to cognitive and behavioral problems. Autism is a neurodevelopmental disorder that is characterized by impaired social interactions and aberrant basic information processing. Aberrant brain connectivity patterns have indeed been hypothesized to be a key neural underpinning of autism. In this study, graph analytical tools are used to explore the possible deviant functional brain network organization in autism at a very early stage of brain development. Electroencephalography (EEG) recordings in 12 toddlers with autism (mean age 3.5 years) and 19 control subjects were used to assess interregional functional brain connectivity, with functional brain networks constructed at the level of temporal synchronization between brain regions underlying the EEG electrodes. Children with autism showed a significantly increased normalized path length and reduced normalized clustering, suggesting a reduced global communication capacity already during early brain development. In addition, whole brain connectivity was found to be significantly reduced in these young patients suggesting an overall under-connectivity of functional brain networks in autism. Our findings support the hypothesis of abnormal neural communication in autism, with deviating effects already present at the early stages of brain development.

Symptom dimensions are associated with progressive brain volume changes in schizophrenia.

BACKGROUND There is considerable variation in progressive brain volume changes in schizophrenia. Whether this is related to the clinical heterogeneity that characterizes the illness remains to be determined. This study examines the relationship between change in brain volume over time and individual variation in psychopathology, as measured by five continuous symptom dimensions (i.e. negative, positive, disorganization, mania and depression). METHODS Global brain volume measurements from 105 schizophrenia patients and 100 healthy comparison subjects, obtained at inclusion and 5-year follow-up, were used in this study. Symptom dimension scores were calculated by factor analysis of clinical symptoms. Using linear regression analyses and independent-samples t-tests, the relationship between symptom dimensions and progressive brain volume changes, corrected for age, gender and intracranial volume, was examined. Antipsychotic medication, outcome and IQ were investigated as potential confounders. RESULTS In patients, the disorganization dimension was associated with change in total brain (β=-0.295, p=0.003) and cerebellar (β=-0.349, p<0.001) volume. Furthermore, higher levels of disorganization were associated with lower IQ, irrespective of psychiatric status (i.e. patient or control). In healthy comparison subjects, disorganization score was not associated with progressive brain volume changes. CONCLUSION Heterogeneity in progressive brain volume changes in schizophrenia is particularly associated with variation in disorganization. Schizophrenia patients with high levels of disorganization exhibit more progressive decrease of global brain volumes and have lower total IQ. We propose that these patients form a phenotypically and biologically homogenous subgroup that may be useful for etiological (e.g., genetic) studies.

Distinct inter-hemispheric dysconnectivity in schizophrenia patients with and without auditory verbal hallucinations

Evidence from behavioral, electrophysiological and diffusion-weighted imaging studies suggest that schizophrenia patients suffer from deficiencies in bilateral brain communication, and this disruption may be related to the occurrence of auditory verbal hallucinations (AVH). To increase our understanding of aberrant inter-hemispheric communication in relation to AVH, we recruited two groups of first-episode schizophrenia patients: one group with AVH (N = 18 AVH patients) and one without hallucinations (N = 18 Non-AVH patients), and 20 healthy controls. All participants received T1 structural imaging and resting-state fMRI scanning. We adopted a newly developed index, voxel-mirrored homotopic connectivity (VMHC), to quantitatively describe bilateral functional connectivity. The whole-brain VMHC measure was compared among the three groups and correlation analyses were conducted between symptomology scores and neurological measures. Our findings suggest all patients shared abnormalities in parahippocampus and striatum. Aberrant bilateral connectivity of default mode network (DMN), inferior frontal gyrus and cerebellum only showed in AVH patients, whereas aberrances in superior temporal gyrus and precentral gyrus were specific to Non-AVH patients. Meanwhile, inter-hemispheric connectivity of DMN correlated with patients’ symptomatology scores. This study corroborates that schizophrenia is characterized by inter-hemispheric dysconnectivity, and suggests the localization of such abnormalities may be crucial to whether auditory verbal hallucinations develop.

Disturbed grey matter coupling in schizophrenia

In schizophrenia, grey matter deficits have been shown for many regions throughout the brain. These regions do not operate in isolation. Rather, they form a structural network of interconnected grey matter regions. To examine the mutual dependence of brain regions, this study investigated interregional coupling in lobar and regional grey matter volumes obtained from 146 schizophrenia patients and 122 healthy comparison subjects. Compared to healthy controls, schizophrenia patients showed both decreased (e.g. between left frontal and bilateral subcortical, p≤0.005) and increased (e.g. between left temporal and bilateral subcortical, p≤0.001) coupling between lobar grey matter volumes. On a regional scale, decreased coupling was most pronounced between fronto-parietal cortical regions and subcortical structures, and between frontal and occipital regions. In addition, an increased association was found among frontal and limbic regions, and for temporo-occipital connexions. Consistent with dysconnectivity theories of schizophrenia, impaired grey matter coupling may be reflective of reduced integrity of the brains network. Furthermore, as cross-sectional volumetric coupling is indicative of maturational coupling, aberrant grey matter coupling may be a marker of neurodevelopmental abnormalities in schizophrenia.

Brain network analysis reveals affected connectome structure in bipolar I disorder

The notion that healthy brain function emerges from coordinated neural activity constrained by the brains network of anatomical connections—i.e., the connectome—suggests that alterations in the connectomes wiring pattern may underlie brain disorders. Corroborating this hypothesis, studies in schizophrenia are indicative of altered connectome architecture including reduced communication efficiency, disruptions of central brain hubs, and affected “rich club” organization. Whether similar deficits are present in bipolar disorder is currently unknown. This study examines structural connectome topology in 216 bipolar I disorder patients as compared to 144 healthy controls, focusing in particular on central regions (i.e., brain hubs) and connections (i.e., rich club connections, interhemispheric connections) of the brains network. We find that bipolar I disorder patients exhibit reduced global efficiency (−4.4%, P =0.002) and that this deficit relates (r = 0.56, P < 0.001) to reduced connectivity strength of interhemispheric connections (−13.0%, P = 0.001). Bipolar disorder patients were found not to show predominant alterations in the strength of brain hub connections in general, or of connections spanning brain hubs (i.e., “rich club” connections) in particular (all P > 0.1). These findings highlight a role for aberrant brain network architecture in bipolar I disorder with reduced global efficiency in association with disruptions in interhemispheric connectivity, while the central “rich club” system appears not to be particularly affected. Hum Brain Mapp 37:122–134, 2016.