News and Commentary Archive

Explore recent scientific discoveries and news as well as CLBB events, commentary, and press.

Mission

The speed of technology in neuroscience as it impacts ethical and just decisions in the legal system needs to be understood by lawyers, judges, public policy makers, and the general public. The Massachusetts General Hospital Center for Law, Brain, and Behavior is an academic and professional resource for the education, research, and understanding of neuroscience and the law. Read more

McLean OnTrack: A Transdiagnostic Program for Early Intervention in First-Episode Psychosis

By Ann K. Shinn, Kirsten W. Bolton, Rakesh Karmacharya, Kathryn E. Lewandowski, Cagri Yuksel, Justin T. Baker, Virginie-Anne Chouinard, Samira M. Pingali, Hilary Bye, Katherine Cederbaum, and Dost Öngür | Early Intervention in Psychiatry | November 29, 2015

Abstract:

Aims

Most programs specializing in the treatment of first-episode psychosis in the United States focus on schizophrenia. However, many early psychosis patients do not fit into this diagnostic category. Here we describe McLean OnTrack, an intensive outpatient treatment program that accepts all comers with first-episode psychosis.

Methods

We assessed baseline characteristics of patients in the 2.5 years since program initiation. We examined how initial referral diagnoses compare with current diagnoses, calculating the proportion of diagnostic changes.

Results

At 2.5 years, patients in McLean OnTrack consist of 30 (33.0%) individuals with primary psychotic disorder, 40 (44.0%) with affective psychosis, 19 (20.9%) with psychotic disorder not otherwise specified (NOS) who do not meet full criteria for either category and two (2.2%) individuals with no psychosis. Although patients with affective psychosis had higher pre-morbid functioning, all three categories of psychosis had similar rates of prior hospitalizations and substance use. The retention rate in the psychotic disorder NOS group was lower than that in affective and primary psychotic disorders. Finally, diagnoses changed over the course of treatment in 50.5% of patients.

Conclusions

Diagnostic heterogeneity appears to be the norm among patients with first-episode psychosis, and diagnoses commonly evolve over the illness course. Baseline indices of illness severity were similar across categories and suggest the need for early intervention, irrespective of specific diagnosis. We discuss the benefits and challenges of a transdiagnostic approach to early intervention in first-episode psychosis, treating patients who share many but not all characteristics.

Read the entire paper here.

Alterations of Lateral Temporal Cortical Gray Matter and Facial Memory as Vulnerability Indicators for Schizophrenia: An MRI Study in Youth at Familial High-Risk for Schizophrenia

By Benjamin K. Brent, Isabelle M. Rosso, Heidi W. Thermenos, Daphne J. Holt, Stephen V. Faraone, Nikos Makris, Ming T. Tsuang, and Larry J. Seidman | Schizophrenia Research | November 24, 2015

Abstract:

Background

Structural alterations of the lateral temporal cortex (LTC) in association with memory impairments have been reported in schizophrenia. This study investigated whether alterations of LTC structure were linked with impaired facial and/or verbal memory in young first-degree relatives of people with schizophrenia and, thus, may be indicators of vulnerability to the illness.

Methods

Subjects included 27 non-psychotic, first-degree relatives of schizophrenia patients, and 48 healthy controls, between the ages of 13 and 28. Participants underwent high-resolution magnetic resonance imaging (MRI) at 1.5 Tesla. The LTC was parcellated into superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus, and temporal pole. Total cerebral and LTC volumes were measured using semi-automated morphometry. The Wechsler Memory Scale — Third Edition and the Children’s Memory Scale — Third Edition assessed facial and verbal memory. General linear models tested for associations among LTC subregion volumes, familial risk and memory.

Results

Compared with controls, relatives had significantly smaller bilateral middle temporal gyri. Moreover, right middle temporal gyral volume showed a significant positive association with delayed facial memory in relatives.

Conclusion

These results support the hypothesis that smaller middle temporal gyri are related to the genetic liability to schizophrenia and may be linked with reduced facial memory in persons at genetic risk for the illness. The findings add to the growing evidence that children at risk for schizophrenia on the basis of positive family history have cortical and subcortical structural brain abnormalities well before psychotic illness occurs.

Read the full article here.

From Mind Wandering to Involuntary Retrieval: Age-Related Differences in Spontaneous Cognitive Processes

By David Maillet and Daniel L. Schacter | Neuropsychologia | November 23, 2015

Abstract:

The majority of studies that have investigated the effects of healthy aging on cognition have focused on age-related differences in voluntary and deliberately engaged cognitive processes. Yet many forms of cognition occur spontaneously, without any deliberate attempt at engaging them. In this article we review studies that have assessed age-related differences in four such types of spontaneous thought processes: mind-wandering, involuntary autobiographical memory, intrusive thoughts, and spontaneous prospective memory retrieval. These studies suggest that older adults exhibit a reduction in frequency of both mind-wandering and involuntary autobiographical memory, whereas findings regarding intrusive thoughts have been more mixed. Additionally, there is some preliminary evidence that spontaneous prospective memory retrieval may be relatively preserved in aging. We consider the roles of age-related differences in cognitive resources, motivation, current concerns and emotional regulation in accounting for these findings. We also consider age-related differences in the neural correlates of spontaneous cognitive processes.

Read the full article here.

Chism Defense to Focus on Juvenile Brain Development as Prosecution Rests

By Rupa Shenoy | WGBH | December 1, 2015

The murder trial of 16-year-old Philip Chism case is playing out as the state and country dramatically changes the way it adjudicates juvenile crime. For the defense team, that means there are very specific things to prove as the jury decides whether Chism is or is not guilty by reason of insanity.

Prosecutors for the Commonwealth rested their case Monday against Chism, who is charged with first-degree murder with atrocity and cruelty. Chism, of Danvers, is charged as an adult in the death of his math teacher, Colleen Ritzer. Continue reading »

Evaluating the Relationship between Cannabis Use and IQ in Youth and Young Adults at Clinical High Risk of Psychosis

By Lisa Buchy, Larry J. Seidman, Kristin S. Cadenhead, Tyrone D. Cannon, Barbara A. Cornblatt, Thomas H. McGlashan, Diana O. Perkins, William Stone, Ming T. Tsuang, Elaine F. Walker, Scott W. Woods, Carrie E. Bearden, Daniel H. Mathalon, and Jean Addington | Psychiatry Research | November 20, 2015

Abstract:

Among people with psychosis, those with a history of cannabis use show better cognitive performance than those who are cannabis naïve. It is unknown whether this pattern is present in youth at clinical high risk (CHR) of psychosis. We evaluated relationships between IQ and cannabis use while controlling for use of other substances known to impact cognition in 678 CHR and 263 healthy control (HC) participants. IQ was estimated using the Vocabulary and Block Design subtests of the Wechsler Abbreviated Scale of Intelligence. Drug and alcohol use severity and frequency were assessed with the Alcohol and Drug Use Scale, and we inquired participants’ age at first use. CHR were further separated into early and late age at onset of cannabis use sub-groups, and low-, moderate- and high-frequency sub-groups. No significant differences in IQ emerged between CHR or HC cannabis users vs. non-users, or between use frequency groups. CHR late-onset users showed significantly higher IQ than CHR early-onset users. Age at onset of cannabis use was significantly and positively correlated with IQ in CHR only. Results suggest that age at onset of cannabis may be a more important factor for IQ than use current use or use frequency in CHR.

Read the entire paper here.