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JAMA Psychiatry. 2014 Feb;71(2):109-18. doi: 10.1001/jamapsychiatry.2013.3469.

Disruption of cortical association networks in schizophrenia and psychotic bipolar disorder.

Author information

1
Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts2Department of Psychiatry, Massachusetts General Hospital, Boston3Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts.
2
Department of Psychiatry, Massachusetts General Hospital, Boston3Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts4Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston.
3
Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts.
4
Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston5Center for Cognitive Neuroscience, Duke-NUS Graduate Medical School, Singapore.
5
Center for Brain Science, Department of Psychology, Harvard University, Cambridge, Massachusetts.
6
Department of Psychiatry, Massachusetts General Hospital, Boston3Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts4Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston6Center for Brain Scienc.
7
Psychotic Disorders Division, McLean Hospital, Belmont, Massachusetts3Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts.

Abstract

IMPORTANCE:

Psychotic disorders (including schizophrenia, schizoaffective disorder, and psychotic bipolar disorder) are devastating illnesses characterized by breakdown in the integration of information processing. Recent advances in neuroimaging allow for the estimation of brain networks on the basis of intrinsic functional connectivity, but the specific network abnormalities in psychotic disorders are poorly understood.

OBJECTIVE:

To compare intrinsic functional connectivity across the cerebral cortex in patients with schizophrenia spectrum disorders or psychotic bipolar disorder and healthy controls.

DESIGN, SETTING, AND PARTICIPANTS:

We studied 100 patients from an academic psychiatric hospital (28 patients with schizophrenia, 32 patients with schizoaffective disorder, and 40 patients with bipolar disorder with psychosis) and 100 healthy controls matched for age, sex, race, handedness, and scan quality from December 2009 to October 2011.

MAIN OUTCOMES AND MEASURES:

Functional connectivity profiles across 122 regions that covered the entire cerebral cortex.

RESULTS:

Relative to the healthy controls, individuals with a psychotic illness had disruption across several brain networks, with preferential reductions in functional connectivity within the frontoparietal control network (P < .05, corrected for family-wise error rate). This functionally defined network includes portions of the dorsolateral prefrontal cortex, posteromedial prefrontal cortex, lateral parietal cortex, and posterior temporal cortex. This effect was seen across diagnoses and persisted after matching patients and controls on the basis of scan quality.

CONCLUSIONS AND RELEVANCE:

Our study results support the view that cortical information processing is disrupted in psychosis and provides new evidence that disruptions within the frontoparietal control network may be a shared feature across both schizophrenia and affective psychosis.

PMID:
24306091
PMCID:
PMC4435541
DOI:
10.1001/jamapsychiatry.2013.3469
[Indexed for MEDLINE]
Free PMC Article

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