Publications by authors named "Ulrika Evermann"

6 Publications

  • Page 1 of 1

Subclinical schizotypal vs. autistic traits show overlapping and diametrically opposed facets in a non-clinical population.

Schizophr Res 2021 Mar 18;231:32-41. Epub 2021 Mar 18.

Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany; Marburg University Hospital - UKGM, Marburg, Germany.

Background: The overlap of autism spectrum disorder (ASD) and psychosis or schizophrenia spectrum disorders (SSD) has exposed problems central to conceptualising and understanding co-morbidity in psychiatric disorders.

Methods: In the present study, we demonstrate that a deep phenotyping approach aids clarification of both overlapping and diametrically opposed features of ASD and SSD on the level of trait facets.

Results: We first show overlap of negative and disorganised (but not positive) features of schizotypy with autistic traits in a sample of n = 376 German non-clinical subjects using multiple psychometric measures of schizotypy (MSS multidimensional schizotypy scale, OLIFE Oxford-Liverpool Inventory of Feelings and Experiences, and SPQ-B schizotypal personality questionnaire - brief) and the AQ autism spectrum quotient, with control measures for affective spectrum pathology (BDI). Findings were then replicated in a French-Swiss sample (n = 264) using MSS, OLIFE, AQ, and in addition the Community Assessment of Psychic Experiences (CAPE). Additional principal component analysis confirmed our finding of the co-existence of both overlapping (loss of function, social communication deficit, and negative schizotypy) as well as diametrically opposed features (AQ attention to detail, positive schizotypy) across the two spectra. Results were validated with Horn's parallel analyses, affirming two component solutions, and PCA using sample-specific, factor-analysis-derived schizotypy scores.

Conclusions: Providing a framework for multi-dimensional transdiagnostic characterisation of ASD vs. SSD phenotypes we point out overlapping vs. discriminating facets. In addition to the use of novel multidimensional schizotypy scales, it also shows transcultural consistency of findings, and highlights a particular role for the attention to detail AQ subscale.
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http://dx.doi.org/10.1016/j.schres.2021.02.018DOI Listing
March 2021

Associations of subclinical autistic-like traits with brain structural variation using DTI and VBM.

Eur Psychiatry 2021 Mar 3:1-38. Epub 2021 Mar 3.

Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-University Marburg / Marburg University Hospital - UKGM, Marburg, Germany.

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http://dx.doi.org/10.1192/j.eurpsy.2021.15DOI Listing
March 2021

Distress severity in perceptual anomalies moderates the relationship between prefrontal brain structure and psychosis proneness in nonclinical individuals.

Eur Arch Psychiatry Clin Neurosci 2021 Feb 2. Epub 2021 Feb 2.

Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.

In the general population, psychosis risk phenotypes occur independently of attenuated prodromal syndromes. Neurobiological correlates of vulnerability could help to understand their meaningfulness. Interactions between the occurrence of psychotic-like experiences (PLE) and other psychological factors e.g., distress related to PLE, may distinguish psychosis-prone individuals from those without risk of future psychotic disorder. We aimed to investigate whether (a) correlates of total PLE and distress, and (b) symptom dimension-specific moderation effects exist at the brain structural level in non-help-seeking adults reporting PLE below and above the screening criterion for clinical high-risk (CHR). We obtained T1-weighted whole-brain MRI scans from 104 healthy adults from the community without psychosis CHR states for voxel-based morphometry (VBM). Brain structural associations with PLE and PLE distress were analysed with multiple linear regression models. Moderation of PLE by distress severity of two types of positive symptoms from the Prodromal Questionnaire (PQ-16) screening inventory was explored in regions-of-interest after VBM. Total PQ-16 score was positively associated with grey matter volume (GMV) in prefrontal regions, occipital fusiform and lingual gyri (p < 0.05, FDR peak-level corrected). Overall distress severity and GMV were not associated. Examination of distress severity on the positive symptom dimensions as moderators showed reduced strength of the association between PLE and rSFG volume with increased distress severity for perceptual PLE. In this study, brain structural variation was related to PLE level, but not distress severity, suggesting specificity. In healthy individuals, positive relationships between PLE and prefrontal volumes may indicate protective features, which supports the insufficiency of PLE for the prediction of CHR. Additional indicators of vulnerability, such as distress associated with perceptual PLE, change the positive brain structure relationship. Brain structural findings may strengthen clinical objectives through disentanglement of innocuous and risk-related PLE.
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http://dx.doi.org/10.1007/s00406-020-01229-5DOI Listing
February 2021

Cortical Gyrification, Psychotic-Like Experiences, and Cognitive Performance in Nonclinical Subjects.

Schizophr Bull 2020 12;46(6):1524-1534

Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany.

Background: Psychotic-like experiences (PLE) are present in nonclinical populations, yet their association with brain structural variation, especially markers of early neurodevelopment, is poorly understood. We tested the hypothesis that cortical surface gyrification, a putative marker of early brain development, is associated with PLE in healthy subjects.

Methods: We analyzed gyrification from 3 Tesla MRI scans (using CAT12 software) and PLE (positive, negative, and depressive symptom dimensions derived from the Community Assessment of Psychic Experiences, CAPE) in 103 healthy participants (49 females, mean age 29.13 ± 9.37 years). A subsample of 63 individuals completed tasks from the Wechsler Adult Intelligence Scale and Controlled Oral Word Association Test. Estimated IQ and a composite neuropsychological score were used to explore mediation pathways via cognition.

Results: Positive PLE distress was negatively associated with gyrification of the left precuneus. PLE depression dimension showed a negative association with gyrification in the right supramarginal and temporal region. There was no significant mediating effect of cognition on these associations.

Conclusion: Our results support a neurobiological psychosis spectrum, for the first time linking an early developmental imaging marker (rather than volume) to dimensional subclinical psychotic symptoms. While schizophrenia risk, neurodevelopment, and cognitive function might share genetic risk factors, additional mediation analyses did not confirm a mediating effect of cognition on the gyrification-psychopathology correlation.
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http://dx.doi.org/10.1093/schbul/sbaa068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707080PMC
December 2020

Anterior vs Posterior Hippocampal Subfields in an Extended Psychosis Phenotype of Multidimensional Schizotypy in a Nonclinical Sample.

Schizophr Bull 2021 Jan;47(1):207-218

Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.

Numerous studies have implicated involvement of the hippocampus in the etiology and expression of schizophrenia-spectrum psychopathology, and reduced hippocampal volume is one of the most robust brain abnormalities reported in schizophrenia. Recent studies indicate that early stages of schizophrenia are specifically characterized by reductions in anterior hippocampal volume; however, studies have not examined hippocampal volume reductions in subclinical schizotypy. The present study was the first to examine the associations of positive, negative, and disorganized schizotypy dimensions with hippocampal subfield volumes in a large sample (n = 195) of nonclinically ascertained young adults, phenotyped using the Multidimensional Schizotypy Scale (MSS). Hippocampal subfields were analyzed from high-resolution 3 Tesla structural magnetic resonance imaging scans testing anatomical models, including anterior vs posterior regions and the cornu ammonis (CA), dentate gyrus (DG), and subiculum subfields separately for the left and right hemispheres. We demonstrate differential spatial effects across anterior vs posterior hippocampus segments across different dimensions of the schizotypy risk phenotype. The interaction of negative and disorganized schizotypy robustly predicted left hemisphere volumetric reductions for the anterior and total hippocampus, and anterior CA and DG, and the largest reductions were seen in participants high in negative and disorganized schizotypy. These findings extend previous early psychosis studies and together with behavioral studies of hippocampal-related memory impairments provide the basis for a dimensional neurobiological hippocampal model of schizophrenia risk. Subtle hippocampal subfield volume reductions may be prevalent prior to the onset of detectable prodromal clinical symptoms of psychosis and play a role in the etiology and development of such conditions.
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http://dx.doi.org/10.1093/schbul/sbaa099DOI Listing
January 2021

Efficacy of Systolic Extinction Training in Fibromyalgia Patients With Elevated Blood Pressure Response to Stress: A Tailored Randomized Controlled Trial.

Arthritis Care Res (Hoboken) 2019 05;71(5):678-688

Center for Pain Research on Impact, Measurement, and Effectiveness, University of Washington, Seattle.

Objective: An intrinsic pain regulatory system is modulated by both cardiovascular dynamics that influence baroreflex sensitivity (BRS) and is diminished in fibromyalgia (FM). Baroreceptors relay cardiovascular output to the dorsal medial nucleus tractus solitarius reflex arcs that regulate pain, sleep, anxiety, and blood pressure. The aim of this study was to evaluate the effects of systolic extinction training (SET), which combines operant treatment (OT) with baroreflex training (BRT). BRT delivers peripheral electrical stimulation within a few milliseconds of the systolic or diastolic peak in the cardiac cycle. In addition, we compared SET to OT-transcutaneous electrical stimulation (TENS) independent of the cardiac cycle and aerobic exercise (AE)-BRT in FM patients with elevated blood pressure responses to stress.

Methods: Sixty-two female patients with FM were randomized to receive either SET (n = 21), OT-TENS (n = 20), or AE-BRT (n = 21). Outcome assessments were performed before treatment (T1), after 5 weeks of treatment (T2), and after the 12-month follow-up (T3).

Results: In contrast to patients receiving OT-TENS or AE-BRT, those receiving SET reported a significantly greater reduction in pain and pain interference (all P < 0.01) that was maintained at the 12-month follow-up. Clinically meaningful pain reduction at T3 was achieved in 82% of patients in the SET group, 39% of those in the OT-TENS group, and only 14% of those in the AE-BRT group. Patients in the SET group showed a significant increase (57%) in BRS following treatment, while neither the AE-BRT group or the OT-TENS group showed significant changes over time.

Conclusion: SET resulted in statistically significant, clinically meaningful, and long-lasting pain remission and interference compared to OT-TENS and AE-BRT. These results suggest that BRS modification is the primary mechanism of improvement. Replication of our results using larger samples and extension to other chronic pain conditions appear to be warranted.
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http://dx.doi.org/10.1002/acr.23615DOI Listing
May 2019