Metabolite abnormalities in psychosis risk: A meta-analysis of proton magnetic resonance spectroscopy studies.

Accumulating evidence implicates that individuals at high-risk of psychosis have already exhibited pathophysiological changes in brain metabolites including glutamate, gamma-Aminobutyric Acid (GABA), N-Acetylaspartate (NAA), creatine (Cr), myo-inositol (MI) and choline (Cho). These changes may contribute to the development of schizophrenia and associate with psychotic genes. However, specific metabolic changes of brain sub-regions in individuals at risk have still been controversial. Thus, the current study aimed to investigate the brain metabolic changes including glutamate, Glx, GABA, GABA/Glx, NAA, Cr, MI and Cho levels in individuals at risk by conducting a case-control meta-analysis and meta-regression of proton magnetic resonance spectroscopy studies. Primary outcomes revealed that individuals at risk exhibited increased Cr levels at the rostral medial prefrontal cortex (rmPFC), decreased NAA and Cr levels at the thalamus, and increased MI levels at the dorsolateral prefrontal cortex. Sub-group analyses further indicated that individuals with clinical high-risk (CHR) exhibited increased Cr levels at the medial prefrontal cortex (mPFC) and decreased Glx levels at the thalamus, while individuals with genetic risk (siblings of psychiatric patients) exhibited significant increased Glx and MI levels at the mPFC. However, GABA, GABA/Glx and Cho levels showed no significant result. These findings suggest that the dysfunctional metabolites at the mPFC and the thalamus may be an essential neurobiological basis at the early stage of psychosis.

Trajectories of schizotypy and their emotional and social functioning: An 18-month follow-up study.

Schizotypy is a set of personality traits that convey liability to develop schizophrenia. Studying schizotypy in healthy individuals may facilitate the understanding of the psychopathological processes underlying schizophrenia. The present study aimed to examine the developmental trajectories of schizotypy over time using a longitudinal study design. The Chapman Scales for Psychosis Proneness were administered to 1541 college students at baseline, and subsequently at six-monthly intervals up to 18months. Latent class growth analysis was conducted to track the different trajectories. In addition, self-reported scales were used to measure idea of reference, emotional experiences and expression, stress and coping, as well as social functioning. We identified four latent classes with distinct trajectories: "nonschizotypy" group (LC1), "stable high schizotypy" group (LC3), "high reactive schizotypy" group (LC2) and "low reactive schizotypy" group (LC4). These findings suggest that there may be distinct developmental trajectories for schizotypy. Two groups may be of particular interest: the "stable high schizotypy" group that displayed the worst clinical and functioning outcomes on almost all measures and the "high reactive schizotypy" group characterized by a relatively rapid decline in functioning.

The effects of working memory training on enhancing hedonic processing to affective rewards in individuals with high social anhedonia.

Anhedonia is a core feature of the negative symptoms of schizophrenia and is less responsive to antipsychotic medication. Little is known whether anhedonia could be alleviated by cognitive training. The present study aimed to examine whether hedonic deficits observed in individuals with high social anhedonia could be reduced by working memory (WM) training. Thirty-four individuals with high social anhedonia were randomly assigned to either a WM training group or a control group. The WM training group received 20 sessions of dual n-back task training for four weeks. The affective incentive delay task was administered in all participants before the training and one month later. The results showed that individuals who received the WM training showed significant improvement in WM performance (F(19, 304)=55.80, p<0.001) and they also showed significant improvement in approach sensitivity to rewards (p=0.004). These preliminary findings suggest that hedonic processing could be improved through WM training in individuals with high social anhedonia. These results may have important implications for the development of non-pharmacological interventions to alleviate anhedonia in patients with schizophrenia.

The neuroplastic effect of working memory training in healthy volunteers and patients with schizophrenia: Implications for cognitive rehabilitation.

We conducted an activation likelihood estimation (ALE) meta-analysis to quantitatively review the existing working memory (WM) training studies that investigated neural activation changes both in healthy individuals and patients with schizophrenia. ALE analysis of studies in healthy individuals indicates a widespread distribution of activation changes with WM training in the frontal and parietal regions, especially the dorsolateral prefrontal cortex, the medial frontal cortex and the precuneus, as well as subcortical regions such as the insula and the striatum. WM training is also accompanied by activation changes in patients with schizophrenia, mainly in the dorsolateral prefrontal cortex, the precuneus and the fusiform gyrus. Our results demonstrate that WM training is accompanied by changes in neural activation patterns in healthy individuals, which may provide the basis for understanding neuroplastic changes in patients with schizophrenia.