Background
Schizophrenia and bipolar disorder share overlapping symptoms and genetic etiology.
Functional brain dysconnectivity is seen in both disorders.
Methods
We compared 70 schizophrenia and 64 psychotic bipolar probands, their respective unaffected
first-degree relatives (n = 70, and n = 52), and 118 healthy subjects, all group age-, gender-, and ethnicity-matched.
We used functional network connectivity analysis to measure differential connectivity
among 16 functional magnetic resonance imaging resting state networks. First, we examined
connectivity differences between probands and control subjects. Next, we probed these
dysfunctional connections in relatives for potential endophenotypes. Network connectivity
was then correlated with Positive and Negative Syndrome Scale (PANSS) scores to reveal
clinical relationships.
Results
Three different network pairs were differentially connected in probands (false-discovery
rate corrected q < .05) involving five individual resting-state networks: (A) fronto/occipital,
(B) anterior default mode/prefrontal, (C) meso/paralimbic, (D) fronto-temporal/paralimbic,
and (E) sensory-motor. One abnormal pair was unique to schizophrenia, (C-E), one unique
to bipolar, (C-D), and one (A-B) was shared. Two of these three combinations (A-B,
C-E) were also abnormal in bipolar relatives but none was normal in schizophrenia
relatives (nonsignificant trend for C-E). The paralimbic circuit (C-D), which uniquely
distinguished bipolar probands, contained multiple mood-relevant regions. Network
relationship C-D correlated significantly with PANSS negative scores in bipolar probands,
and A-B with PANSS positive and general scores in schizophrenia.
Conclusions
Schizophrenia and psychotic bipolar probands share several abnormal resting state
network connections, but there are also unique neural network underpinnings between
disorders. We identified specific connections that might also be candidate psychosis
endophenotypes.
Key Words
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Article info
Publication history
Published online: March 09, 2012
Accepted:
January 31,
2012
Received in revised form:
January 31,
2012
Received:
May 10,
2011
Identification
Copyright
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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- Functional Network Endophenotypes of Psychotic DisordersBiological PsychiatryVol. 71Issue 10
- PreviewOne of the pivotal diagnostic distinctions in psychiatry is between bipolar disorder and schizophrenia. Manic depressive psychosis was distinguished from psychosis in general in the 19th century and, following Kraepelin's work in the early 20th century, schizophrenia was differentiated in terms of its phenomenology and natural history. Although this clinical compartmentalization of psychosis has been useful and enduring, there is increasing evidence that under the hood of the classically different phenotypes there may be more in common between bipolar disorder and schizophrenia than a strict Kraepelinian dichotomy would predict (1).
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