Browsing by Author "Ramirez-Mahaluf, Juan P."
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- ItemDysconnectivity in Schizophrenia Revisited: Abnormal Temporal Organization of Dynamic Functional Connectivity in Patients With a First Episode of Psychosis(2023) Ramirez-Mahaluf, Juan P.; Tepper, Angeles; Maria Alliende, Luz; Mena, Carlos; Castaneda, Carmen Paz; Iruretagoyena, Barbara; Nachar, Ruben; Reyes-Madrigal, Francisco; Leon-Ortiz, Pablo; Mora-Duran, Ricardo; Ossandon, Tomas; Gonzalez-Valderrama, Alfonso; Undurraga, Juan; De la Fuente-Sandoval, Camilo; Crossley, Nicolas A.Background and Hypothesis Abnormal functional connectivity between brain regions is a consistent finding in schizophrenia, including functional magnetic resonance imaging (fMRI) studies. Recent studies have highlighted that connectivity changes in time in healthy subjects. We here examined the temporal changes in functional connectivity in patients with a first episode of psychosis (FEP). Specifically, we analyzed the temporal order in which whole-brain organization states were visited. Study Design Two case-control studies, including in each sample a subgroup scanned a second time after treatment. Chilean sample included 79 patients with a FEP and 83 healthy controls. Mexican sample included 21 antipsychotic-naive FEP patients and 15 healthy controls. Characteristics of the temporal trajectories between whole-brain functional connectivity meta-states were examined via resting-state functional MRI using elements of network science. We compared the cohorts of cases and controls and explored their differences as well as potential associations with symptoms, cognition, and antipsychotic medication doses. Study Results We found that the temporal sequence in which patients' brain dynamics visited the different states was more redundant and segregated. Patients were less flexible than controls in changing their network in time from different configurations, and explored the whole landscape of possible states in a less efficient way. These changes were related to the dose of antipsychotics the patients were receiving. We replicated the relationship with antipsychotic medication in the antipsychotic-naive FEP sample scanned before and after treatment. Conclusions We conclude that psychosis is related to a temporal disorganization of the brain's dynamic functional connectivity, and this is associated with antipsychotic medication use.
- ItemStructural brain abnormalities in schizophrenia in adverse environments: Examining the effect of poverty and violence in six Latin American cities(2021) Crossley Karmelic, Nicolás Andrés; Zugman, Andre; Reyes-Madrigal, Francisco; Czepielewski, Leticia S.; Castro, Mariana N.; Díaz-Zuluaga, Ana M.; Pineda-Zapata, Julián A.; Reckziegel, Ramiro; Noto, Cristiano; Jackowski, Andrea; Alliende, Luz M.; Iruretagoyena, Bárbara; Ossandon, Tomás; Ramirez-Mahaluf, Juan P.; Castañeda, Carmen; González-Valderrama, Alfonso; Nachar, Rubén; León-Ortiz, Pablo; Undurraga, Juan; López-Jaramillo, Carlos; Guinjoan, Salvador; Gama, Clarissa; Fuente-Sandoval, Camilo de la; Bressan, RodrigoBackground: Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear. Aims: We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed. Method: This is a multicentre study of magnetic resonance imaging in patients with schizophrenia andcontrols fromsixLatinAmerican cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model. Results: Atotal of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P=0.006). Controls showed a positive correlation between total grey matter volume and The risk of developing schizophrenia is modulated, among other factors, by the social and environmental context of where people live. Incidence rates of psychosis are different across countries,1 possibly reflecting variations in the environment. Proposed specific factors explaining this effect have included an urban upbringing,2 poverty3 and the neighbourhood crime rate.4 Where people live has also been related to recovery rates of schizophrenia, in the context of whether it is a low- or high-income country5 or experiencing periods of economic expansion or recession.6 Brain imaging studies have shown that many of these environmental factors are related to brain changes in healthy individuals. For example, young people raised in poverty in high-income countries show reductions in total brain grey matter.7 Exposure to childhood adversity and violence has also been related to differences in hippocampal and amygdala volumes.8 An unresolved question relates to how these environmental factors affect the biology of schizophrenia. Couldbraindifferences typically seen in patients with schizophrenia be accounted for by these environmental factors? How will the neuropathology of schizophrenia interact with brain changes related to the environment? Is there a double-hit situation, where * Joint last authors. 112 income(R=0.14, P=0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R=−0.076, P=0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.