Identifying both the commonalities and differences in brain structures among psychiatric disorders is important for understanding the pathophysiology. Recently, the ENIGMA-Schizophrenia DTI Working ...Group performed a large-scale meta-analysis and reported widespread white matter microstructural alterations in schizophrenia; however, no similar cross-disorder study has been carried out to date. Here, we conducted mega-analyses comparing white matter microstructural differences between healthy comparison subjects (HCS; N = 1506) and patients with schizophrenia (N = 696), bipolar disorder (N = 211), autism spectrum disorder (N = 126), or major depressive disorder (N = 398; total N = 2937 from 12 sites). In comparison with HCS, we found that schizophrenia, bipolar disorder, and autism spectrum disorder share similar white matter microstructural differences in the body of the corpus callosum; schizophrenia and bipolar disorder featured comparable changes in the limbic system, such as the fornix and cingulum. By comparison, alterations in tracts connecting neocortical areas, such as the uncinate fasciculus, were observed only in schizophrenia. No significant difference was found in major depressive disorder. In a direct comparison between schizophrenia and bipolar disorder, there were no significant differences. Significant differences between schizophrenia/bipolar disorder and major depressive disorder were found in the limbic system, which were similar to the differences in schizophrenia and bipolar disorder relative to HCS. While schizophrenia and bipolar disorder may have similar pathological characteristics, the biological characteristics of major depressive disorder may be close to those of HCS. Our findings provide insights into nosology and encourage further investigations of shared and unique pathophysiology of psychiatric disorders.
Subcortical structures, which include the basal ganglia and parts of the limbic system, have key roles in learning, motor control and emotion, but also contribute to higher-order executive functions. ...Prior studies have reported volumetric alterations in subcortical regions in schizophrenia. Reported results have sometimes been heterogeneous, and few large-scale investigations have been conducted. Moreover, few large-scale studies have assessed asymmetries of subcortical volumes in schizophrenia. Here, as a work completely independent of a study performed by the ENIGMA consortium, we conducted a large-scale multisite study of subcortical volumetric differences between patients with schizophrenia and controls. We also explored the laterality of subcortical regions to identify characteristic similarities and differences between them. T1-weighted images from 1680 healthy individuals and 884 patients with schizophrenia, obtained with 15 imaging protocols at 11 sites, were processed with FreeSurfer. Group differences were calculated for each protocol and meta-analyzed. Compared with controls, patients with schizophrenia demonstrated smaller bilateral hippocampus, amygdala, thalamus and accumbens volumes as well as intracranial volume, but larger bilateral caudate, putamen, pallidum and lateral ventricle volumes. We replicated the rank order of effect sizes for subcortical volumetric changes in schizophrenia reported by the ENIGMA consortium. Further, we revealed leftward asymmetry for thalamus, lateral ventricle, caudate and putamen volumes, and rightward asymmetry for amygdala and hippocampal volumes in both controls and patients with schizophrenia. Also, we demonstrated a schizophrenia-specific leftward asymmetry for pallidum volume. These findings suggest the possibility of aberrant laterality in neural pathways and connectivity patterns related to the pallidum in schizophrenia.
The effect of duration of illness and antipsychotic medication on the volumes of subcortical structures in schizophrenia is inconsistent among previous reports. We implemented a large sample analysis ...utilizing clinical data from 11 institutions in a previous meta-analysis.
Imaging and clinical data of 778 schizophrenia subjects were taken from a prospective meta-analysis conducted by the COCORO consortium in Japan. The effect of duration of illness and daily dose and type of antipsychotics were assessed using the linear mixed effect model where the volumes of subcortical structures computed by FreeSurfer were used as a dependent variable and age, sex, duration of illness, daily dose of antipsychotics and intracranial volume were used as independent variables, and the type of protocol was incorporated as a random effect for intercept. The statistical significance of fixed-effect of dependent variable was assessed.
Daily dose of antipsychotics was positively associated with left globus pallidus volume and negatively associated with right hippocampus. It was also positively associated with laterality index of globus pallidus. Duration of illness was positively associated with bilateral globus pallidus volumes. Type of antipsychotics did not have any effect on the subcortical volumes.
A large sample size, uniform data collection methodology and robust statistical analysis are strengths of the current study. This result suggests that we need special attention to discuss about relationship between subcortical regional brain volumes and pathophysiology of schizophrenia because regional brain volumes may be affected by antipsychotic medication.
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•The imaging data as well as prescription data and demographics from 778 patients with schizophrenia from 11 institutions were included.•The effect of protocol was cooperated as random-effect in the linear mixed-effect model.•Significant positive association were found between daily dose of antipsychotics and left globus pallidus volume.•Significant negative association was found between daily dose of antipsychotics and right hippocampus volume.•Significant positive associations were found between duration of illness and bilateral volumes of globus pallidus.
A detailed overview of the knowledge gaps in our understanding of the heliospheric interaction with the largely unexplored Very Local Interstellar Medium (VLISM) are provided along with predictions ...of with the scientific discoveries that await. The new measurements required to make progress in this expanding frontier of space physics are discussed and include in-situ plasma and pick-up ion measurements throughout the heliosheath, direct sampling of the VLISM properties such as elemental and isotopic composition, densities, flows, and temperatures of neutral gas, dust and plasma, and remote energetic neutral atom (ENA) and Lyman-alpha (LYA) imaging from vantage points that can uniquely discern the heliospheric shape and bring new information on the interaction with interstellar hydrogen. The implementation of a pragmatic Interstellar Probe mission with a nominal design life to reach 375 Astronomical Units (au) with likely operation out to 550 au are reported as a result of a 4-year NASA funded mission study.
Aim
Studies have reported that cognitive decline occurs after the onset of schizophrenia despite heterogeneity in cognitive function among patients. The aim of this study was to investigate the ...degree of estimated cognitive decline in patients with schizophrenia by comparing estimated premorbid intellectual functioning and current intellectual functioning.
Methods
A total of 446 patients with schizophrenia (228 male, 218 female), consisting of three sample sets obtained from 11 psychiatric facilities, and 686 healthy controls participated in this study. The Wechsler Adult Intelligence Scale‐III (WAIS‐III) was used to measure the participants’ current full‐scale IQ (FSIQ). The premorbid IQ was estimated using the Japanese Adult Reading Test‐25. Estimated cognitive decline (difference score) was defined as the difference between the estimated premorbid IQ and the current FSIQ.
Results
Patients with schizophrenia showed greater estimated cognitive decline, a lower FSIQ, and a lower premorbid IQ compared with the healthy controls. The mean difference score, FSIQ, and estimated premorbid IQ were −16.3, 84.2, and 100.5, respectively, in patients with schizophrenia. Furthermore, 39.7% of the patients had a difference score of 20 points or greater decline. A discriminant analysis showed that the difference score accurately predicted 81.6% of the patients and healthy controls.
Conclusion
These results show the distribution of difference score in patients with schizophrenia. These findings may contribute to assessing the severity of estimated cognitive decline and identifying patients with schizophrenia who suffer from cognitive decline.
Historical heliophysics missions have flown variations of an instrument intended to measure the electric fields and plasma waves of the inner heliosphere. A similar instrument is currently being ...investigated as part of the NASA funded Interstellar Probe (ISP) study. This instrument consists of two pairs of long thin wire antennas (also referenced as booms) deployed radially with small tip masses at the end of each, extending approximately 100 m (or more) tip-to-tip. The booms are deployed on a spinning spacecraft using centripetal acceleration to hold them in place. These booms account for the majority of the spacecraft moments of inertia, even though they represent only a small fraction of the total spacecraft mass. The booms introduce dynamical forces such as coning and nutation which greatly complicate communications through a high gain antenna (HGA) at large distances from the Earth. For a mission to the outer heliosphere, and into interstellar space, careful analyses must be conducted to ensure the HGA can be stably pointed with its boresight close enough to Earth to maintain adequate uplink and downlink data rates for science and engineering data during all major activities, and ensure the health and safety of the spacecraft from launch through end of life. As the booms greatly increase the inertia properties of the spacecraft, they increase the angular momentum of the spacecraft at a given spin rate, requiring more propellant for precession maneuvers and spin rate adjustments. Time must be allocated between maneuvers to allow for nutation to damp, and periodic re-calibrations of the HGA boresight to principal moment of inertia may be required. These further complicate operations, and add risk that must be managed. This paper will detail the various effects, challenges, and risks introduced by long wire antennas to a spinning spacecraft. It will discuss the potential risks and complexities associated with deployment of the booms. It will detail how the static effects such as coning between the HGA boresight and the spin axis, and the transient dynamic events like nutation of the hub and mutual precession of the hub-boom system, can affect downlink rates. It covers some of the operational considerations introduced such as propellant usage and how to precess a system safely with such low frequency modes. This paper includes historical spacecraft dynamics data from the Van Allen Probes, whose Electric Fields and Waves instrument is being considered as a template for an outer heliophysics spacecraft. Finally, it presents some examples of missions that have flown booms similar to the ones being studied, and how they differ from ISP. This paper will detail the various effects, challenges, and risks introduced by long wire antennas to a spinning spacecraft. It will discuss the potential risks and complexities associated with deployment of the booms. It will detail how the static effects such as coning between the HGA boresight and the spin axis, and the transient dynamic events like nutation of the hub and mutual precession of the hub-boom system, can affect downlink rates. It covers some of the operational considerations introduced such as propellant usage and how to precess a system safely with such low frequency modes. This paper includes historical spacecraft dynamics data from the Van Allen Probes, whose Electric Fields and Waves instrument is being considered as a template for an outer heliophysics spacecraft. Finally, it presents some examples of missions that have flown booms similar to the ones being studied, and how they differ from ISP.
During the course of its evolution, our Sun and its protective magnetic bubble have plowed through dramatically different interstellar environments throughout the galaxy. The vast range of conditions ...of interstellar plasma, gas, dust and high-energy cosmic rays on this “solar journey” have helped shape the solar system that we live in. Today, our protective bubble, or Heliosphere, is likely about to enter a completely new regime of interstellar space that will, yet again, change the entire heliospheric interaction and how it shields us from the interstellar environment. Interstellar Probe is a mission concept to explore the mechanisms shaping our heliosphere and represents the first step beyond our home, into the interstellar cloud to understand the evolutionary journey of our Sun, Heliosphere and Solar System. The idea of an Interstellar Probe dates back to the 1960's, when also the ideas of a probe to the Sun and its poles were formed. An international team of scientists and a team of engineers at the Johns Hopkins University Applied Physics Laboratory (APL) are funded by NASA to study pragmatic mission concepts that would make a launch in the 2030's a reality. The ground breaking science enabled by such a mission spans not only the discipline of Solar and Space Physics, but also Planetary Sciences and Astrophysics. Detailed analyses including the upcoming SLS Block 2 and powerful stages demonstrate that asymptotic speeds around 7 Astronomical Units (au) per Year are already possible with a Jupiter Gravity Assist. Here, we give an overview of the science discoveries that await along the journey, including the physics of the heliospheric boundary and interstellar medium, the potential for exploration of Kuiper Belt Objects, the circum-solar dust disk and the extra-galactic background light. The scientific rationale, investigations and implementation of an Interstellar Probe are discussed including also example payload, trajectory design and operations.
•Interstellar Probe is a mission concept to take the first step in to the galaxy.•It will explore the Sun's protective magnetic bubble harboring the entire solar system.•Beyond the bubble it will sample the interstellar medium for the first time.•A speed of 7–8 astronomical units per year is achieved by conventional means.•The concept is undergoing a four-year study concluding in early 2022.
Influenza has been associated with the risk of developing Parkinson disease, but the association is controversial.
To examine whether prior influenza and other infections are associated with ...Parkinson disease more than 10 years after infection.
This case-control study used data from 1977 to 2016 from the Danish National Patient Registry. All individuals with Parkinson disease, excluding those with drug-induced parkinsonism, were included and matched to 5 population controls on sex, age, and date of Parkinson diagnosis. Data were analyzed from December 2019 to September 2021.
Infections were ascertained between 1977 and 2016 and categorized by time from infection to Parkinson disease diagnosis. To increase specificity of influenza diagnoses, influenza exposure was restricted to months of peak influenza activity.
Parkinson disease diagnoses were identified between January 1, 2000, and December 31, 2016. Crude and adjusted odds ratios (ORs) and 95% CIs were calculated by conditional logistic regression overall and stratified by time between infection and Parkinson disease (5 years or less, more than 5 to 10 years, more than 10 years).
Of 61 626 included individuals, 23 826 (38.7%) were female, and 53 202 (86.3%) were older than 60 years. A total of 10 271 individuals with Parkinson disease and 51 355 controls were identified. Influenza diagnosed at any time during a calendar year was associated with Parkinson disease more than 10 years later (OR, 1.73; 95% CI, 1.11-2.71). When influenza exposure was restricted to months of highest influenza activity, an elevated OR with a wider confidence interval was found (OR, 1.52; 95% CI, 0.80-2.89). There was no evidence of an association with any type of infection more than 10 years prior to Parkinson disease (OR, 1.04; 95% CI, 0.98-1.10). Several specific infections yielded increased odds of Parkinson disease within 5 years of infection, but results were null when exposure occurred more than 10 years prior.
In this case-control study, influenza was associated with diagnoses of Parkinson disease more than 10 years after infection. These observational data suggest a link between influenza and Parkinson disease but do not demonstrate causality. While other infections were associated with Parkinson disease diagnoses soon after infection, null associations after more than 10 years suggest these shorter-term associations are not causal.
Lyme disease surveillance based on provider and laboratory reports underestimates incidence. We developed an algorithm for automating surveillance using electronic health record data. We identified ...potential Lyme disease markers in electronic health record data (laboratory tests, diagnosis codes, prescriptions) from January 2017-December 2018 in 2 large practice groups in Massachusetts, USA. We calculated their sensitivities and positive predictive values (PPV), alone and in combination, relative to medical record review. Sensitivities ranged from 57% (95% CI 47%-69%) for immunoassays to 87% (95% CI 70%-100%) for diagnosis codes. PPVs ranged from 53% (95% CI 43%-61%) for diagnosis codes to 58% (95% CI 50%-66%) for immunoassays. The combination of a diagnosis code and antibiotics within 14 days or a positive Western blot had a sensitivity of 100% (95% CI 86%-100%) and PPV of 82% (95% CI 75%-89%). This algorithm could make Lyme disease surveillance more efficient and consistent.Lyme disease surveillance based on provider and laboratory reports underestimates incidence. We developed an algorithm for automating surveillance using electronic health record data. We identified potential Lyme disease markers in electronic health record data (laboratory tests, diagnosis codes, prescriptions) from January 2017-December 2018 in 2 large practice groups in Massachusetts, USA. We calculated their sensitivities and positive predictive values (PPV), alone and in combination, relative to medical record review. Sensitivities ranged from 57% (95% CI 47%-69%) for immunoassays to 87% (95% CI 70%-100%) for diagnosis codes. PPVs ranged from 53% (95% CI 43%-61%) for diagnosis codes to 58% (95% CI 50%-66%) for immunoassays. The combination of a diagnosis code and antibiotics within 14 days or a positive Western blot had a sensitivity of 100% (95% CI 86%-100%) and PPV of 82% (95% CI 75%-89%). This algorithm could make Lyme disease surveillance more efficient and consistent.
Viral respiratory illness surveillance has traditionally focused on single pathogens (e.g., influenza) and required fever to identify influenza-like illness (ILI). We developed an automated system ...applying both laboratory test and syndrome criteria to electronic health records from 3 practice groups in Massachusetts, USA, to monitor trends in respiratory viral-like illness (RAVIOLI) across multiple pathogens. We identified RAVIOLI syndrome using diagnosis codes associated with respiratory viral testing or positive respiratory viral assays or fever. After retrospectively applying RAVIOLI criteria to electronic health records, we observed annual winter peaks during 2015-2019, predominantly caused by influenza, followed by cyclic peaks corresponding to SARS-CoV-2 surges during 2020-2024, spikes in RSV in mid-2021 and late 2022, and recrudescent influenza in late 2022 and 2023. RAVIOLI rates were higher and fluctuations more pronounced compared with traditional ILI surveillance. RAVIOLI broadens the scope, granularity, sensitivity, and specificity of respiratory viral illness surveillance compared with traditional ILI surveillance.
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