Cognitive Event-Related Brain Potentials and MRI in Psychosis Dean - - PowerPoint PPT Presentation

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Cognitive Event-Related Brain Potentials and MRI in Psychosis Dean - - PowerPoint PPT Presentation

Feb 05, 2024 486 likes •653 views

Cognitive Event-Related Brain Potentials and MRI in Psychosis Dean F Salisbury, PhD Cognitive Neuroscience Laboratory, McLean Hospital Harvard Medical School, Boston, Massachusetts, USA High-Resolution Measures of Brain Function and Brain

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Cognitive Event-Related Brain Potentials and MRI in Psychosis

Dean F Salisbury, PhD

Cognitive Neuroscience Laboratory, McLean Hospital Harvard Medical School, Boston, Massachusetts, USA

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High-Resolution Measures of Brain Function and Brain Structure

Two techniques to examine the physiology of attention in schizophrenia EEG – Millisecond temporal resolution of brain activity at the speed of thought. Poor localization of generator sources in isolation. MRI – Millimeter spatial resolution of anatomy. Pure anatomy. Allows for measurement of the volume of gray and white matter in areas identified as EEG generator sites through invasive depth-recordings.

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Temporal Lobe - STG

  • Heschl’s gyrus (HG) Contains

primary auditory cortex. Analysis

  • f simple acoustic features (e.g.,

pitch)

  • Moderate bilateral gray matter

volume reduction in First- Episode Schizophrenia vs. Mania and Controls

  • Planum

Temporale (PT) Secondary and tertiary auditory

  • cortex. Analysis of complex

acoustic features (e.g., speech)

  • Marked left hemisphere gray

matter volume reduction in First- Episode Schizophrenia vs. Mania and Controls.

  • L. HG
  • L. PT

Hirayasu et al., Arch Gen Psych, 2000; 57: 692 -699

Auditory Processing

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100 200 300 400 500 600 700 800

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Time (ms) 5 10 15

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Amplitude (µV)

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Time (ms)

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Amplitude (µV)

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A m p l i t u d e ( µ V )

Con [n=14] FE Sz [n=14] FE AFF [n=14]

ERP Waveforms

Fz Cz Pz T3 T4

FIRST EPISODE PSYCHOSIS STUDY

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100 200 300 400 500 600 700 800

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Time (ms)

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Amplitude (µV)

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Amplitude (µV) Con (n=14) FE Sz (n=14) FE AFF (n=14)

Temporal Electrode Sites

DF Salisbury, ME Shenton, AR Sherwood, IA Fischer, DA Yurgelun-Todd, M Tohen, RW McCarley. (1998). First episode schizophrenic psychosis differs from first episode affective psychosis and controls in P300 amplitude over left temporal lobe. Archives of General Psychiatry, 55: 173-180.

FIRST EPISODE PSYCHOSIS STUDY

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Time 1 P300 expanded samples

Sz (N= 54) Aff (N= 59) Con (N= 55)

Omnibus midline sites test Group: F(2,165) = 5.3, p =.006 Site: F(2,165) = 236.7, p <.0001 Group x Site: F(4,165) = 4.2, p <.01 Omnibus lateral sites test Group: F(2,165) = 6.1, p =.003 Hemisphere: F(1,165) =2.5, p =.12 Group x Hemisphere: F(2,165) = 6.8, p =.001

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2 4 6 8 10 12 [µV] 100 200 300 400 500 600 700 [m s]

Fz Raw Data Raw Data

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Cz Raw Data Raw Data

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Pz Raw Data Raw Data

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T 3 Raw Data Raw Data

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2 4 6 8 1 1 2 [µV ] 1 2 3 4 5 6 7 [m s]

T 4 Raw Data Raw Data

Fz Cz Pz T3 T4

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2 4 6 8 10 4 6 8 Left Posterior STG Volume (ml) P e a k P 300 A m p litu d e a t T 3 (µV )

r = 0.52 p =.047

First Episode Schizophrenia (n = 15)

STG Volume & P3 are Related at First Episode

McCarley et al., Archives of General Psychiatry, 2002, 59: 321-331

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Kasai et al., Am J Psychiatry, 2003

Left posterior STG gray matter volume change over time

12/13 decrease (mean ~ 9%)

SCZ (N=13) NCL (N=14) AFF (N=15)

0.30 0.40 0.50 0.60

Relative volume of left posterior STG

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  • 5.0

0.0 5.0 10.0

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0.0 5.0 10.0

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Schizophrenia (n = 21) Time1 Time2 Affective (Manic) Psychosis (n = 36) Controls (n = 38)

P3 is not reduced further in the first few years after first hospitalization

Salisbury et al., Unpublished Data

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First Episode Schizophrenia (n=21) Controls (n=27)

Pitch Deviant Mismatch

Fz Pz Cz T3 T4

Salisbury et al., Archives of General Psychiatry, 2002, 59: 686-694

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  • 10.0
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0.0 0.5 1.5 2.5 Left HG Volume

Mismatch Negativity Amplitude

Left HG Volume Left HG Volume Schizophrenia (n = 20) Controls (n = 32) Affective (Manic) Psychosis (n = 21)

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r = -.52 p = .02 r = .02 p = .94 r = -.12 p = .51

MMN Amplitude Correlates with Left Heschl’s Gyrus Volume in First-Episode Schizophrenia

Salisbury et al., Archives of General Psychiatry, In Press

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Fz Grand Average

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Fz Grand Average

Schizophrenia (n = 16) Controls (n = 20) Affective (Manic) Psychosis (n = 17) MMN Time 1 Time 2

Pitch Deviant Mismatch Follow-up MMN

Salisbury et al., Archives of General Psychiatry, In Press

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%Change in Gray Matter Volume

Left Heschl's Gyrus Left Planum Temporale

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%Change in Gray Matter Volume

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Right Heschl's Gyrus Right Planum Temporale

Schizophrenia (n = 13) Affective (n = 15) Controls (n = 22) Schizophrenia (n = 13) Affective (n = 15) Controls (n = 22) Kasai K et al., Archives Gen

  • Psychiatry. 2003; 60:766-775

% Change in Heschl’s Gyrus and Planum Temporale gray matter volume

  • ver 1.5 years
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0.2 Left HG Volume Change Schizophrenia (n = 11)

MMN Amplitude Change

r = .62 p = .04

Controls (n = 13) Left HG Volume Change

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1.0 3.0

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0.2

r = -.01 p > .98

Affective (Manic) Psychosis (n = 13) Left HG Volume Change

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1.0 3.0

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0.2

r = .33 p > .27 Reductions in MMN Amplitude Correlate with Reductions in Left Heschl’s Gyrus Gray Matter Volume at 1.5 Year Retest

Salisbury et al., Archives of General Psychiatry, In Press

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Combined High Temporal Resolution and High Structural Resolution Brain Measures

Combined ERP & MRI measures allow one to target generator sites of physiological activity related to cognitive activation and their pathology In this example, abnormal physiology associated with structural brain changes during the early stages of schizophrenia. This finding, in turn, may identify new therapeutic targets ERPs associated with specific processing activity can be measured in other domains, such as facial affect identification, or lexical and semantic priming, gamma driving (20, 30, 40 Hz input) as a probe of local circuit integrity