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 in | Biological psychiatry (1969) Vol. 72; no. 9; pp. 744 - 751 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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New York, NY
Elsevier Inc
01.11.2012
Elsevier |
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ISSN | 0006-3223 1873-2402 1873-2402 |
DOI | 10.1016/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. |
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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 |
Author_xml | – sequence: 1 givenname: Alkomiet surname: Hasan fullname: Hasan, Alkomiet organization: Department of Psychiatry and Psychotherapy, Georg-August University, Goettingen, Germany – sequence: 2 givenname: Thomas surname: Wobrock fullname: Wobrock, Thomas email: twobroc@gwdg.de organization: Department of Psychiatry and Psychotherapy, Georg-August University, Goettingen, Germany – sequence: 3 givenname: Christian surname: Grefkes fullname: Grefkes, Christian organization: Max Planck Institute for Neurological Research and Department of Neurology, University of Cologne, Cologne, Germany – sequence: 4 givenname: Marcin surname: Labusga fullname: Labusga, Marcin organization: Department of Psychiatry and Psychotherapy, Georg-August University, Goettingen, Germany – sequence: 5 givenname: Katrin surname: Levold fullname: Levold, Katrin organization: Department of Psychiatry and Psychotherapy, Georg-August University, Goettingen, Germany – sequence: 6 givenname: Thomas surname: Schneider-Axmann fullname: Schneider-Axmann, Thomas organization: Department of Psychiatry and Psychotherapy, Georg-August University, Goettingen, Germany – sequence: 7 givenname: Peter surname: Falkai fullname: Falkai, Peter organization: Department of Psychiatry and Psychotherapy, Georg-August University, Goettingen, Germany – sequence: 8 givenname: Hendrik surname: Müller fullname: Müller, Hendrik organization: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany – sequence: 9 givenname: Joachim surname: Klosterkötter fullname: Klosterkötter, Joachim organization: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany – sequence: 10 givenname: Andreas surname: Bechdolf fullname: Bechdolf, Andreas organization: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany |
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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 |
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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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