Evidence map›Paper›PMID 37606273›Full record

ArticleSchizophrenia bulletin2023

Basal-Forebrain Cholinergic Nuclei Alterations are Associated With Medication and Cognitive Deficits Across the Schizophrenia Spectrum.

Julia Schulz, Felix Brandl, Michel J Grothe, Matthias Kirschner, Stefan Kaiser, André Schmidt, Stefan Borgwardt, Josef Priller, Christian Sorg, Mihai Avram

Open access · hybridAbstract read
In one paragraph

Article in Schizophrenia bulletin, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 3 countries.

Julia SchulzTUM-NIC Neuroimaging Center, Technical University of Munich, School of Medicine, Munich, Germany.
Felix BrandlTUM-NIC Neuroimaging Center, Technical University of Munich, School of Medicine, Munich, Germany.
Michel J GrotheUnidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.ORCID 0000-0003-2600-9022
Matthias KirschnerDepartment of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-9486-1439
Stefan KaiserDepartment of Psychiatry, Geneva University Hospital, Geneva, Switzerland.
André SchmidtDepartment of Psychiatry (UPK), University of Basel, Basel, Switzerland.ORCID 0000-0001-6055-8397
Stefan BorgwardtTranslational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
Josef PrillerDepartment of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany.
Christian SorgTUM-NIC Neuroimaging Center, Technical University of Munich, School of Medicine, Munich, Germany.
Mihai AvramTranslational Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.ORCID 0000-0003-2171-8313
Technical University of Munich · DEUniversity of Lübeck · DEInstituto de Biomedicina de Sevilla · ESUniversity Hospital of Geneva · CHUniversity of Basel · CHUniversity of Zurich · CH

Funding

German Federal Ministry of Education and Research BMBF; 01ER0803German Research Council DFG; SO1336/7National Bank Fellowship (McGill University) and the Swiss National Foundation P2SKP3_178175
6 · The paper itself

Abstract

background and hypothesisThe cholinergic system is altered in schizophrenia. Particularly, patients' volumes of basal-forebrain cholinergic nuclei (BFCN) are lower and correlated with attentional deficits. It is unclear, however, if and how BFCN changes and their link to cognitive symptoms extend across the schizophrenia spectrum, including individuals with at-risk mental state for psychosis (ARMS) or during first psychotic episode (FEP). STUDY

designTo address this question, we assessed voxel-based morphometry (VBM) of structural magnetic resonance imaging data of anterior and posterior BFCN subclusters as well as symptom ratings, including cognitive, positive, and negative symptoms, in a large multi-site dataset (n = 4) comprising 68 ARMS subjects, 98 FEP patients (27 unmedicated and 71 medicated), 140 patients with established schizophrenia (SCZ; medicated), and 169 healthy controls.

resultsIn SCZ, we found lower VBM measures for the anterior BFCN, which were associated with the anticholinergic burden of medication and correlated with patients' cognitive deficits. In contrast, we found larger VBM measures for the posterior BFCN in FEP, which were driven by unmedicated patients and correlated at-trend with cognitive deficits. We found no BFCN changes in ARMS. Altered VBM measures were not correlated with positive or negative symptoms.

conclusionsResults demonstrate complex (posterior vs. anterior BFCN) and non-linear (larger vs. lower VBM) differences in BFCN across the schizophrenia spectrum, which are specifically associated both with medication, including its anticholinergic burden, and cognitive symptoms. Data suggest an altered trajectory of BFCN integrity in schizophrenia, influenced by medication and relevant for cognitive symptoms.

Indexed as

Psychotic DisordersSchizophreniaCholinergic AntagonistsCognitionHumansMagnetic Resonance ImagingProsencephalonCholinergic Antagonistscholinergic systemcognitive difficultiesfirst-episode psychosismagnetic resonance imaging

Identifiers

PMID37606273
PMCPMC10686329
OpenAlexW4386046752

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.