Deficient Inhibitory Cortical Networks in Antipsychotic-Naive Subjects at Risk of Developing First-Episode Psychosis and First-Episode Schizophrenia Patients: A Cross-Sectional Study

Impaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic transmission. However, there have been no previous studies investigating cortical excitability with particular regard to intracortical inhibit...

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Published inBiological psychiatry (1969) Vol. 72; no. 9; pp. 744 - 751
Main Authors Hasan, Alkomiet, Wobrock, Thomas, Grefkes, Christian, Labusga, Marcin, Levold, Katrin, Schneider-Axmann, Thomas, Falkai, Peter, Müller, Hendrik, Klosterkötter, Joachim, Bechdolf, Andreas
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.11.2012
Elsevier
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Online AccessGet full text
ISSN0006-3223
1873-2402
1873-2402
DOI10.1016/j.biopsych.2012.03.005

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Abstract Impaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic transmission. However, there have been no previous studies investigating cortical excitability with particular regard to intracortical inhibitory networks in antipsychotic-naive subjects at risk of developing first-episode psychosis. A total of 18 subjects at risk, 18 first-episode schizophrenia patients, and 18 healthy control subjects were included in this study. Transcranial magnetic stimulation over the left primary motor cortex was used to determine short-latency intracortical inhibition, intracortical facilitation, and the contralateral silent period (CSP). Short-latency intracortical inhibition can be considered as a parameter of GABA type A (GABAA)-mediated inhibition and it has been proposed that CSP can test GABA type B (GABAB)-mediated inhibitory intracortical networks. Subjects at risk and first-episode patients showed a reduced short-latency intracortical inhibition compared with healthy control subjects, suggesting reduced GABAA-mediated inhibition. First-episode patients had a prolonged CSP duration compared with the other two groups, implying a GABAB imbalance only in patients with full-blown psychosis. Analyses did not reveal group differences for intracortical facilitation. These results indicate specific alterations in inhibitory cortical networks in subjects at risk and in first-episode patients. It appears that there is already a cortical inhibitory deficit in at-risk individuals. These results suggest a possible GABAA dysfunction early in the disease course, whereas alterations in GABAB functionality seem to occur later in the disease's progression. Future longitudinal studies will be needed to clarify this inhibitory deficit and its relation to the transition to psychosis.
AbstractList Impaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic transmission. However, there have been no previous studies investigating cortical excitability with particular regard to intracortical inhibitory networks in antipsychotic-naive subjects at risk of developing first-episode psychosis. A total of 18 subjects at risk, 18 first-episode schizophrenia patients, and 18 healthy control subjects were included in this study. Transcranial magnetic stimulation over the left primary motor cortex was used to determine short-latency intracortical inhibition, intracortical facilitation, and the contralateral silent period (CSP). Short-latency intracortical inhibition can be considered as a parameter of GABA type A (GABA(A))-mediated inhibition and it has been proposed that CSP can test GABA type B (GABA(B))-mediated inhibitory intracortical networks. Subjects at risk and first-episode patients showed a reduced short-latency intracortical inhibition compared with healthy control subjects, suggesting reduced GABA(A)-mediated inhibition. First-episode patients had a prolonged CSP duration compared with the other two groups, implying a GABA(B) imbalance only in patients with full-blown psychosis. Analyses did not reveal group differences for intracortical facilitation. These results indicate specific alterations in inhibitory cortical networks in subjects at risk and in first-episode patients. It appears that there is already a cortical inhibitory deficit in at-risk individuals. These results suggest a possible GABA(A) dysfunction early in the disease course, whereas alterations in GABA(B) functionality seem to occur later in the disease's progression. Future longitudinal studies will be needed to clarify this inhibitory deficit and its relation to the transition to psychosis.
Impaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic transmission. However, there have been no previous studies investigating cortical excitability with particular regard to intracortical inhibitory networks in antipsychotic-naive subjects at risk of developing first-episode psychosis.BACKGROUNDImpaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic transmission. However, there have been no previous studies investigating cortical excitability with particular regard to intracortical inhibitory networks in antipsychotic-naive subjects at risk of developing first-episode psychosis.A total of 18 subjects at risk, 18 first-episode schizophrenia patients, and 18 healthy control subjects were included in this study. Transcranial magnetic stimulation over the left primary motor cortex was used to determine short-latency intracortical inhibition, intracortical facilitation, and the contralateral silent period (CSP). Short-latency intracortical inhibition can be considered as a parameter of GABA type A (GABA(A))-mediated inhibition and it has been proposed that CSP can test GABA type B (GABA(B))-mediated inhibitory intracortical networks.METHODSA total of 18 subjects at risk, 18 first-episode schizophrenia patients, and 18 healthy control subjects were included in this study. Transcranial magnetic stimulation over the left primary motor cortex was used to determine short-latency intracortical inhibition, intracortical facilitation, and the contralateral silent period (CSP). Short-latency intracortical inhibition can be considered as a parameter of GABA type A (GABA(A))-mediated inhibition and it has been proposed that CSP can test GABA type B (GABA(B))-mediated inhibitory intracortical networks.Subjects at risk and first-episode patients showed a reduced short-latency intracortical inhibition compared with healthy control subjects, suggesting reduced GABA(A)-mediated inhibition. First-episode patients had a prolonged CSP duration compared with the other two groups, implying a GABA(B) imbalance only in patients with full-blown psychosis. Analyses did not reveal group differences for intracortical facilitation.RESULTSSubjects at risk and first-episode patients showed a reduced short-latency intracortical inhibition compared with healthy control subjects, suggesting reduced GABA(A)-mediated inhibition. First-episode patients had a prolonged CSP duration compared with the other two groups, implying a GABA(B) imbalance only in patients with full-blown psychosis. Analyses did not reveal group differences for intracortical facilitation.These results indicate specific alterations in inhibitory cortical networks in subjects at risk and in first-episode patients. It appears that there is already a cortical inhibitory deficit in at-risk individuals. These results suggest a possible GABA(A) dysfunction early in the disease course, whereas alterations in GABA(B) functionality seem to occur later in the disease's progression. Future longitudinal studies will be needed to clarify this inhibitory deficit and its relation to the transition to psychosis.CONCLUSIONSThese results indicate specific alterations in inhibitory cortical networks in subjects at risk and in first-episode patients. It appears that there is already a cortical inhibitory deficit in at-risk individuals. These results suggest a possible GABA(A) dysfunction early in the disease course, whereas alterations in GABA(B) functionality seem to occur later in the disease's progression. Future longitudinal studies will be needed to clarify this inhibitory deficit and its relation to the transition to psychosis.
BackgroundImpaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic transmission. However, there have been no previous studies investigating cortical excitability with particular regard to intracortical inhibitory networks in antipsychotic-naive subjects at risk of developing first-episode psychosis. MethodsA total of 18 subjects at risk, 18 first-episode schizophrenia patients, and 18 healthy control subjects were included in this study. Transcranial magnetic stimulation over the left primary motor cortex was used to determine short-latency intracortical inhibition, intracortical facilitation, and the contralateral silent period (CSP). Short-latency intracortical inhibition can be considered as a parameter of GABA type A (GABA A)-mediated inhibition and it has been proposed that CSP can test GABA type B (GABA B)-mediated inhibitory intracortical networks. ResultsSubjects at risk and first-episode patients showed a reduced short-latency intracortical inhibition compared with healthy control subjects, suggesting reduced GABA A-mediated inhibition. First-episode patients had a prolonged CSP duration compared with the other two groups, implying a GABA B imbalance only in patients with full-blown psychosis. Analyses did not reveal group differences for intracortical facilitation. ConclusionsThese results indicate specific alterations in inhibitory cortical networks in subjects at risk and in first-episode patients. It appears that there is already a cortical inhibitory deficit in at-risk individuals. These results suggest a possible GABA A dysfunction early in the disease course, whereas alterations in GABA B functionality seem to occur later in the disease's progression. Future longitudinal studies will be needed to clarify this inhibitory deficit and its relation to the transition to psychosis.
Impaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic transmission. However, there have been no previous studies investigating cortical excitability with particular regard to intracortical inhibitory networks in antipsychotic-naive subjects at risk of developing first-episode psychosis. A total of 18 subjects at risk, 18 first-episode schizophrenia patients, and 18 healthy control subjects were included in this study. Transcranial magnetic stimulation over the left primary motor cortex was used to determine short-latency intracortical inhibition, intracortical facilitation, and the contralateral silent period (CSP). Short-latency intracortical inhibition can be considered as a parameter of GABA type A (GABAA)-mediated inhibition and it has been proposed that CSP can test GABA type B (GABAB)-mediated inhibitory intracortical networks. Subjects at risk and first-episode patients showed a reduced short-latency intracortical inhibition compared with healthy control subjects, suggesting reduced GABAA-mediated inhibition. First-episode patients had a prolonged CSP duration compared with the other two groups, implying a GABAB imbalance only in patients with full-blown psychosis. Analyses did not reveal group differences for intracortical facilitation. These results indicate specific alterations in inhibitory cortical networks in subjects at risk and in first-episode patients. It appears that there is already a cortical inhibitory deficit in at-risk individuals. These results suggest a possible GABAA dysfunction early in the disease course, whereas alterations in GABAB functionality seem to occur later in the disease's progression. Future longitudinal studies will be needed to clarify this inhibitory deficit and its relation to the transition to psychosis.
Author Bechdolf, Andreas
Hasan, Alkomiet
Schneider-Axmann, Thomas
Levold, Katrin
Falkai, Peter
Müller, Hendrik
Labusga, Marcin
Grefkes, Christian
Klosterkötter, Joachim
Wobrock, Thomas
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Issue 9
Keywords GABA
Cortical inhibition
schizophrenia
transcranial magnetic stimulation
prodrome
first-episode schizophrenia
Human
Cerebral cortex
Transcranial magnetic stimulation
Central nervous system
Schizophrenia
Prodrome
Neural network
Encephalon
Psychosis
First episode
Cross sectional study
Risk factor
Neurotransmitter
Development
Inhibition
Language English
License https://www.elsevier.com/tdm/userlicense/1.0
CC BY 4.0
Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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Publisher Elsevier Inc
Elsevier
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Snippet Impaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid (GABA)ergic...
BackgroundImpaired cortical inhibition is a well-established finding in schizophrenia patients and has been linked to dysfunctional gamma-aminobutyric acid...
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SubjectTerms Adult
Adult and adolescent clinical studies
Antipsychotic Agents - pharmacology
Antipsychotic Agents - therapeutic use
Biological and medical sciences
Case-Control Studies
Cerebral Cortex - drug effects
Cerebral Cortex - physiopathology
Cortical inhibition
Cross-Sectional Studies
Electromyography - methods
Evoked Potentials, Motor - drug effects
Evoked Potentials, Motor - physiology
Female
first-episode schizophrenia
GABA
Humans
Male
Medical sciences
Neural Inhibition - drug effects
Neural Inhibition - physiology
prodrome
Psychiatric/Mental Health
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Psychotic Disorders - drug therapy
Psychotic Disorders - physiopathology
Schizophrenia
Schizophrenia - drug therapy
Schizophrenia - physiopathology
transcranial magnetic stimulation
Transcranial Magnetic Stimulation - methods
Title Deficient Inhibitory Cortical Networks in Antipsychotic-Naive Subjects at Risk of Developing First-Episode Psychosis and First-Episode Schizophrenia Patients: A Cross-Sectional Study
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https://dx.doi.org/10.1016/j.biopsych.2012.03.005
https://www.ncbi.nlm.nih.gov/pubmed/22502988
https://www.proquest.com/docview/1093521086
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