Striatal volumes and dyskinetic movements in youth at high-risk for psychosis

Mittal, Vijay A.; Daley, Melita; Shiode, Marisa F.; Bearden, Carrie E.; O’Neill, Joseph; Cannon, Tyrone D.

doi:10.1016/j.schres.2010.08.002

Cited by 48 publications

(55 citation statements)

References 11 publications

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“…Indeed, relevant research in UHR and first episode psychosis patients also shows that motor function associated with neurologic soft sign exams and spontaneous Parkinsonisms predict cognitive impairment and worsening negative symptoms (Cuesta et al, 2014; Dean and Mittal, 2014; Mittal et al, 2014). In contrast to the current results, hyperkinetic movements (e.g., dyskinesias) appear to be more closely linked to aberrant dopaminergic processes and predict exacerbation of positive symptoms (Callaway et al, 2014; Mittal et al, 2010; Mittal et al, 2008; Mittal et al, 2007). …”

Section: Discussioncontrasting

confidence: 99%

Increased postural sway predicts negative symptom progression in youth at ultrahigh risk for psychosis

Dean

Kent

et al. 2015

Schizophrenia Research

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Impaired ability to maintain an upright posture may reflect impairment in the cerebellum, a critical structure for the fluid coordination of neural information, thought to be disrupted in psychosis. The current study utilized an instrumental measure of posture in individuals at ultrahigh risk (UHR) for psychosis (n=43) and healthy controls (n=44). Positive and negative symptoms were assessed twice over 12-months. Results showed that increased postural sway in the UHR group predicted changes in negative symptoms. This study provides an important prospective view on the relationship between cerebellar-sensitive behavior and integral symptoms, which until now has received limited biomarker research.

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Section: Discussioncontrasting

confidence: 99%

Increased postural sway predicts negative symptom progression in youth at ultrahigh risk for psychosis

Dean

Kent

et al. 2015

Schizophrenia Research

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“…It is important to note that our use of TICV allows this study to be compared with the existing literature because this method has been widely used in volumetric studies of UHR and schizophrenia patients (Hannan et al, 2010; Ho, Andreasen, Dawson, & Wassink, 2007; Ho, Andreasen, Ziebell, Pierson, & Magnotta, 2011; Mittal et al, 2010; Sullivan et al, 2000; Velakoulis et al, 2006; Ziermans et al, 2012). However, as alternative techniques become available, researchers in the UHR field will need to take steps to adopt them as well (e.g., a study designed to compare the TICV and TBV methods across brain structures in a large UHR sample).…”

Section: Discussionmentioning

confidence: 99%

“…Second, although our sample size is comparable to that used in many other high-impact UHR structural imaging investigations (Allen et al, 2011; Borgwardt, McGuire, et al, 2007; Borgwardt, Riecher-Rossler, et al, 2007; Broome et al, 2010; Fusar-Poli, Borgwardt, et al, 2011; Fusar-Poli, Broome, et al, 2011; Fusar-Poli, Stone, et al, 2011; Mittal et al, 2010; Morey et al, 2005; Niendam et al, 2006; Sabb et al, 2010; Stone et al, 2009), future studies with larger samples would be beneficial because increased power may allow for detection and control of potential confounding factors, which can threaten internal validity. A third, and related, limitation is the use of only one task to examine procedural learning.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Morphology and Procedural Learning Impairment in Neuroleptic-Naive Youth at Ultrahigh Risk of Psychosis

Dean

Orr

et al. 2013

Clinical Psychological Science

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Despite evidence suggesting a role for cerebellar abnormalities in the pathogenesis of psychosis, the structure has yet to receive attention in individuals at ultrahigh risk for psychosis (UHR). Accumulating research has suggested that the cerebellum helps modulate cognition and movement, domains in which UHR individuals show impairment; understanding putative markers of risk, such as structural abnormalities and behavioral correlates, is essential. In this study, participants underwent a high-resolution structural brain scan and participated in a pursuit rotor experiment. Cerebellar regions associated with movement (anterior cerebellum) and cognition (crus I) were subsequently analyzed. UHR participants showed impaired performance on the pursuit rotor task, learned at a slower rate, and showed smaller cerebellar volumes compared with control participants. Left crus I volume was significantly associated with poor rate of learning. The present results suggest that cerebellar abnormalities and their behavioral correlates (poor learning and motor control) precede the onset of psychosis.

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“…During the adolescent prodromal period, when DA abnormalities escalate, 41 and potentially interact with extant early vulnerabilities (eg, signs of general motor system impairment pinpointed in archival and childhood home-video designs), 38 emerging specific motor signs such as hyperkinetic movements may serve as a highly sensitive prognostic indicator of basal ganglia dysfunction. 42 In support of this theory, prospective investigations in youth with prodromal syndromes have observed that the presence of specific motor abnormalities significantly increases the odds of developing psychosis in a brief 2-year period. 10,43 In a new exciting direction, some work also suggests that cerebellar-specific motor behavior (i.e., balance) may also have unique predictive value for negative symptoms as well.…”

Section: At Issuementioning

confidence: 96%

Cross-Cutting Advancements Usher in a New Era for Motor Research in Psychosis

Mittal

2016

SCHBUL

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As gesture serves as an interaction point between motor, language, and sensory-integration processes, an intersection also implicated in psychosis, schizophrenia researchers have recently turned toward this area as well. 1 The findings of Walther et al 2 move our understanding of this nascent field significantly ahead, with results indicating that deficits in gesture performance and perception are closely tied with clinical and functional outcome in individuals with schizophrenia over a 6-month period. More broadly, this article suggests that a test of hand gesture may provide a viable method for predicting clinical course and potentially highlighting a novel vulnerability subtype in schizophrenia patients. Given the importance of these findings, and the relative ease of such assessments, the questions remain-why are we not seeing more studies like this, and where are the translational applications? Further, in addition to aberrant gesture, schizophrenia has been linked with a range of motor signs including delays in developmental milestones, clumsiness, poor coordination, abnormalities in gait, posture and neuromusculature, diffuse neurological soft signs, catatonia, psychomotor slowing, and both medication-induced and spontaneous hyper/hypo dyskinesias spanning muscle groups throughout the body. Despite the broad array of affected behaviors and characteristics, and the long history of movement and motor research in this area, 3 the question remains, why is this such a neglected area in our field?There are several factors that have been impeding more widespread use of motor variables in cuttingedge research. First, rigid intradisciplinary boundaries between neurology and psychiatry have historically kept abnormalities in movement and socio-emotional behavior distinct. In a related issue, until recently, key relevant target structures such as the basal ganglia and cerebellum have been viewed primarily as a motor centers and related movement behaviors have not been linked into the sophisticated comprehensive models or etiological theories that are often necessary generate enthusiasm about a domain or target. Second, the advent of first-generation antipsychotic medications, which produce characteristic movement disorders in some patients, contributed to further confusion about etiology of movement signs. More broadly, both generations of neuroleptics have also continued to serve as a tricky barrier for definitive research in this area. 4 Third, empirical studies have relied almost entirely on drug-induced motor abnormality assessments, 5 or scales designed to follow diffuse markers (eg, neurological soft signs). 6 While these instruments can be reliable at a particular site, they require highly specialized training, miss more subtle movements, and can press investigators to impose subjective categories on continuous phenotypes. Fourth, although it has been clear for some time that there are motor abnormalities present in psychosis, the translational relevance of these markers is uncertain. Finally, motor behaviors...

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Striatal volumes and dyskinetic movements in youth at high-risk for psychosis

Cited by 48 publications

References 11 publications

Increased postural sway predicts negative symptom progression in youth at ultrahigh risk for psychosis

Increased postural sway predicts negative symptom progression in youth at ultrahigh risk for psychosis

Cerebellar Morphology and Procedural Learning Impairment in Neuroleptic-Naive Youth at Ultrahigh Risk of Psychosis

Cross-Cutting Advancements Usher in a New Era for Motor Research in Psychosis

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