Yingying Tang

• Shanghai Jiao Tong University

To explore the neurobiological heterogeneity within the Clinical High-Risk (CHR) for psychosis population, this study aimed to identify and characterize distinct neurobiological biotypes within CHR using features from resting-state functional networks. A total of 239 participants from the Shanghai At Risk for Psychosis (SHARP) program were enrolled...

Background: Transcranial magnetic stimulation (TMS) is a widely used treatment for major depressive disorders (MDD). However, its physiological effects remain unclear, and its efficacy varies among patients. Functional connectivity (FC) within MDD-related networks has shown potential for predicting TMS efficacy. White matter (WM) micromorphology co...

Background Psychosis is a complex brain disorder with diverse biological subtypes influenced by various pathogenic mechanisms, which can affect treatment efficacy. The ANR(Attenuated Niacin Response) subtype is characterized by pronounced negative symptoms and functional impairments, suggesting a distinct clinical profile. However, research on the...

Schizophrenia is a severe psychiatric disorder characterized by widespread white matter (WM) alterations, manifesting as neurodevelopmental deficits and dysconnectivity abnormalities. Over the past two decades, studies have focused on the clinical high-risk (CHR) stage of psychosis and have yielded fruitful information on WM abnormalities that exis...

Background and objective The dorsolateral prefrontal cortex (DLPFC) - cerebellum circuit has been implicated in the pathogenesis of negative symptoms of schizophrenia (SZ). Both areas are considered separate targets for repetitive transcranial magnetic stimulation (rTMS) treatment, showing potential for improving negative symptoms. However, there i...

The Clinical High Risk (CHR) stage of psychosis is characterized by subthreshold symptoms of schizophrenia including negative symptoms, dysphoric mood, and functional deterioration. Hyperconnectivity of the default-mode network (DMN) has been observed in early schizophrenia, but the extent to which hyperconnectivity is present in CHR, and the exten...

Objectives A seizure lasting >15 s has been considered to indicate treatment for magnetic seizure therapy (MST), a modification of electroconvulsive therapy (ECT), without much validation. This study aimed to investigate whether this seizure duration was suitable for the treatment of schizophrenia. Methods Altogether, 34 and 33 in-patients with sc...

Machine learning can be used to define subtypes of psychiatric conditions based on shared biological foundations of mental disorders. Here we analyzed cross-sectional brain images from 4,222 individuals with schizophrenia and 7038 healthy subjects pooled across 41 international cohorts from the ENIGMA, non-ENIGMA cohorts and public datasets. Using...

Recent studies show that accelerated cortical gray matter (GM) volume reduction seen in anatomical MRI can help distinguish between individuals at clinical high risk (CHR) for psychosis who will develop psychosis and those who will not. This reduction is suggested to represent atypical developmental or degenerative changes accompanying an accumulat...

Schizophrenia lacks a clear definition at the neuroanatomical level, capturing the sites of origin and progress of this disorder. Using a network-theory approach called epicenter mapping on cross-sectional magnetic resonance imaging from 1124 individuals with schizophrenia, we identified the most likely "source of origin" of the structural patholog...

Importance: Schizophrenia is characterized with greater variability beyond the mean differences in brain structures. This variability is often assumed to be static, reflecting the presence of heterogeneous subgroups, but this assumption and alternative explanations remain untested. Objective: To test if gray matter volume (GMV) variability is more...

Background and Hypothesis This review examines the evolution and future prospects of prevention based on evaluation (PBE) for individuals at clinical high risk (CHR) of psychosis, drawing insights from the SHARP (Shanghai At Risk for Psychosis) study. It aims to assess the effectiveness of non-pharmacological interventions in preventing psychosis o...

Background The effects of antipsychotic (AP) medications on cognitive functions in individuals at clinical high-risk (CHR) of psychosis are poorly understood. This study compared the effects of AP treatment on cognitive improvement in CHR adolescents and adults. Methods A total of 327 CHR participants, with an age range of 13 to 45 years, who unde...

Importance Bipolar mania is a common disabling illness. Electroconvulsive therapy (ECT) is an effective treatment for patients with severe mania, though it is limited by the risk of cognitive adverse effects. Magnetic seizure therapy (MST) as an alternative treatment to ECT for bipolar mania has not yet been reported. Objective To compare the effe...

Background Mild cognitive deficits (MCD) emerge before the first episode of psychosis (FEP) and persist in the clinical high-risk (CHR) stage. This study aims to refine risk prediction by developing MCD models optimized for specific early psychosis stages and target populations. Methods A comprehensive neuropsychological battery assessed 1059 indi...

Background and hypothesis Substantive inquiry into the predictive power of eye movement (EM) features for clinical high-risk (CHR) conversion and their longitudinal trajectories is currently sparse. This study aimed to investigate the efficiency of machine learning predictive models relying on EM indices and examine the longitudinal alterations of...

Importance The possible association between the duration of untreated prodromal symptoms (DUPrS) and cognitive functioning in individuals at clinical high risk (CHR) for psychosis remains underexplored. Objective To investigate the intricate interplay between DUPrS, cognitive performance, and conversion outcomes, shedding light on the potential ro...

Introduction Transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (lDLPFC) has been widely used as a treatment for major depressive disorder (MDD) in the past two decades. Different methods for localising the lDLPFC target include the ‘5 cm’ method, the F3 method and the neuro-navigational method. However, whether TM...

Striatal dopaminergic overactivity was hypothesized as the core pathophysiology of schizophrenia. However, morphological alterations of striatum in schizophrenia remains exclusive, largely because brain regional heterogeneity limited traditional group-mean based approach. Leveraging third-party brain maps of neurotransmitter and cognition behaviour...

Psychosis is recognized as one of the largest contributors to nonfatal health loss, and early identification can largely improve routine clinical activity by predicting the psychotic course and guiding treatment. Clinicians have used the clinical high‐risk for psychosis (CHR) paradigm to better understand the risk factors that contribute to the ons...

Pattern separation and pattern completion are opposing yet complementary components of mnemonic processing that heavily rely on the hippocampus. It has been shown that processing within the dentate gyrus (DG) subfield promotes pattern separation while operations within the CA3 subfield are important for pattern completion. Schizophrenia has been as...

Machine learning can be used to define subtypes of psychiatric conditions based on shared clinical and biological foundations, presenting a crucial step toward establishing biologically based subtypes of mental disorders. With the goal of identifying subtypes of disease progression in schizophrenia, here we analyzed cross-sectional brain structural...

Recent studies show that accelerated cortical gray matter (GM) volume reduction seen in anatomical MRI can help distinguish between individuals at clinical high risk (CHR) for psychosis who will develop psychosis and those who will not. This reduction is thought to result from an accumulation of microstructural changes, such as decreased spine dens...

Neurocognitive deficits differ with age during the early stages of psychosis. This study aimed to explore age-related differences (9-35 years old) in the neurocognitive performance of a large clinical population. In total, 1059 individuals with first-episode psychosis (FEP), 794 individuals with a clinical high risk of psychosis (CHR), and 774 well...

Background: Antipsychotic treatment has been shown to yield hippocampal and amygdalar volumetric changes in first-episode schizophrenia (FES). However, whether antipsychotic induced volumetric changes interact with age remains unclear. Methods: The current study includes data from 120 medication naïve FES patients and 110 matched healthy control...

Background and hypothesis: Visual fixation is a dynamic process, with the spontaneous occurrence of microsaccades and macrosaccades. These fixational saccades are sensitive to the structural and functional alterations of the cortical-subcortical-cerebellar circuit. Given that dysfunctional cortical-subcortical-cerebellar circuit contributes to cog...

Objective: Left ventrolateral prefrontal cortex (VLPFC) has been demonstrated to be a crucial region involved in the down-regulation of negative affect by cognitive reappraisal. However, the neural evidence of causality is still lacking. The current study was to investigate the contribution of left VLPFC in cognitive reappraisal by using single-pu...

Technical developments and improved access to neuroimaging techniques have brought us closer to understanding the neuropathological origins of schizophrenia. Using data-driven disease-progression modelling on cross-sectional magnetic resonance imaging (MRI) from 1,124 patients with schizophrenia, we characterize two distinct but stable ‘trajectorie...

This study attempted to construct and validate dynamic prediction via multivariate joint models and compare the prognostic performance of these models to both static and univariate joint models. Individuals with clinical high risk(CHR)(n = 289) were recruited and re-assessed for positive symptoms, general functions, and conversion to psychosis at 2...

Objectives: The efficacy of electroconvulsive therapy (ECT) in treating mood disorders (MDs) is hypothesized to be mediated by the induction of neurotrophic factors (denoted "angioneurins") that trigger neuronal plasticity. This study aimed to assess the effects of ECT on serum angioneurin levels in patients with MD. Methods: A total of 110 pati...

Background and hypothesis: Cognitive deficits in visuospatial learning (VSL) are highly associated with an increased risk of developing psychosis among populations with clinical high risk (CHR) for psychosis. Early interventions targeting VSL enhancement are warranted in CHR but remain rudimentary. We investigated whether personalized transcranial...

Objective: This paper aims to model the anatomical circuits underlying schizophrenia symptoms, and to explore patterns of abnormal connectivity among brain networks affected by psychopathology. Methods: T1 magnetic resonance imaging (MRI), diffusion weighted imaging (DWI), and resting-state functional MRI (rsfMRI) were obtained from a total of 1...

The current concept of clinical high-risk(CHR) of psychosis relies heavily on “below-threshold” (i.e. attenuated or limited and intermittent) psychotic positive phenomena as predictors of the risk for future progression to “above-threshold” positive symptoms (aka “transition” or “conversion”). Positive symptoms, even at attenuated levels are often...

Previous studies have revealed that the imbalance between Th1 cytokines and Th2 cytokines plays a role in disturbance of cellular responses in the brain during psychosis. Cross-sectional studies have implied that inflammatory cytokine changes emerge in early psychosis, even at the at-risk stage. This study aimed to test the hypothesis that inflamma...

Background Clinical high risk (CHR) of psychosis is characterized by cognitive impairment in social interaction. However, research investigating the neurobiological underpinnings of social interactions and interpersonal relationships in CHR participants is sparse. Methods 21 CHR and 54 healthy controls (HCs) participated in the study. Dyads were f...

Metacognition refers to the ability to be aware of one’s own cognition. Ample evidence indicates that metacognition in the human primate is highly dissociable from cognition, specialized across domains, and subserved by distinct neural substrates. However, these aspects remain relatively understudied in macaque monkeys. In the present study, we inv...

Eye movement abnormalities have been established as an “endophenotype” of schizophrenia. However, less is known about the possibility of these abnormalities as biomarkers for psychosis conversion among clinical high risk (CHR) populations. In the present study, 108 CHR individuals and 70 healthy controls (HC) underwent clinical assessments and eye-...

Individuals at clinical high risk (CHR) for psychosis exhibit a compromised mismatch negativity (MMN) response, which indicates dysfunction of pre‐attentive deviance processing. Event‐related potential and time‐frequency (TF) information, in combination with clinical and cognitive profiles, may provide insight into the pathophysiology and psychopat...

We studied brain changes during an N-back task before and after 10 sessions of transcranial direct current stimulation (tDCS) and its relation to cognitive changes. This was a double-blind, sham-controlled, randomized study of tDCS in 27 patients with schizophrenia. They performed an N-back task in a 3 T scanner before and after receiving the 10 tD...

Objective Although existing guidelines have discouraged use of antipsychotics for general clinical high-risk (CHR) individuals, it is unclear if antipsychotics can prevent psychosis in higher-risk population. We aimed to study the comparative real-world effectiveness of antipsychotic treatments for preventing psychosis in higher-risk CHR individual...

Poor cognitive insight, including low self-reflectiveness and high self-certainty, contributes to poor clinical insight, which includes awareness of illness, relabelling of specific symptoms, and treatment compliance. However, inconsistent results regarding cognitive insight among individuals at clinical high risk of psychosis (CHR) have been repor...

Hippocampal deficits and metabolic dysregulations such as dyslipidemia have been frequently reported in schizophrenia and are suggested to contribute to the pathophysiology of schizophrenia. Hippocampus is particularly susceptible to environmental challenges including metabolism and inflammation. However, evidence linking hippocampal alterations an...

Previous studies have demonstrated that decreased gray matter volume (GMV) correlates with cognitive function in elderly patients with mild cognitive impairment (MCI). However, it is unclear whether those correlations are present in MCI patients with depressive symptoms (MCID). This study investigated the association among depressive symptoms, GMV...

Background Self-reflectiveness, one dimension of cognitive insight, plays a protective role in an individual’s mental state. Both high and low levels of self-reflectiveness have been reported in patients with schizophrenia and individuals at clinical high risk for the illness. Aims This study aimed to explore the relationship patterns between self...

Background: Neural oscillations directly reflect the rhythmic changes of brain activities during the resting state or while performing specific tasks. Abnormal neural oscillations have been discovered in patients with schizophrenia. However, there is limited evidence available on abnormal spontaneous neural oscillations in clinical high risk for p...

Background Depression is a common debilitating mental disorder caused by various factors. Identifying and diagnosing depression are challenging because the clinical evaluation of depression is mainly subjective, lacking objective and quantitative indicators. The present study investigated the value and significance of eye movement measurements in d...

Background Disrupted white matter (WM) microstructure has been commonly identified in youth at clinical high risk (CHR) for psychosis. Several lines of evidence suggest that fatty acids, especially unsaturated fatty acids (UFAs), might play a crucial role in the WM pathology of early onset psychosis. However, evidence linking UFA and WM microstruct...

Objective: Current treatment guidelines for individuals at clinical high risk (CHR) for psychosis do not recommend the prescription of antipsychotics (not even second-generation ones) as the first treatment option for preventing psychosis. Yet, recent meta-analytic evidence indicates that antipsychotic exposure in CHR is relatively widespread and a...

Background Previous research has reported that patients with schizophrenia would regard false memories with higher confidence, and this meta-memory deficit was suggested as a neurocognitive marker of schizophrenia. However, how schizophrenia patients determine their memory decision confidence has received scant consideration. This study, therefore,...

Recent evidence highlights the role of the cerebellum-cerebral loop in the pathophysiology of schizophrenia (SZ). Electroconvulsive therapy (ECT) is clinically applied to augment the effect of antipsychotic drugs. The study aims to address whether the cerebellum-cerebral loop is involved in the mechanisms of ECT's augmentation effect. Forty-two SZ...

Electroconvulsive therapy (ECT) can effectively reduce the symptoms of schizophrenia, but may also impair cognitive function. A potential alternative is magnetic seizure therapy (MST), which has shown comparable efficacy with less severe cognitive disruption. This study compared ECT to MST for clinical efficacy and cognitive side effects. In additi...

[This corrects the article DOI: 10.3389/fpsyt.2021.753130.].

Patients with schizophrenia show widespread impairments in clinical, cognitive and psychosocial functioning. Mismatch negativity (MMN) and gamma-band auditory steady-state response (ASSR) are two neurophysiological biomarkers widely used to inform diagnosis, guide treatments and track response to interventions in schizophrenia. However, evidence fo...

Background : Late-onset Alzheimer’s disease (LOAD) and early-onset Alzheimer’s disease (EOAD) are different subtypes of AD. This study aimed to build and validate radiomics models of the hippocampus for EOAD and young controls (YCs), LOAD and old controls (OCs), as well as EOAD and LOAD. Methods : Thirty-six EOAD patients, 36 LOAD patients, 36 YCs,...

Background Schizophrenia is a severely debilitating psychiatric disorder with high heritability and polygenic architecture. A higher polygenic risk score for schizophrenia (SzPRS) has been associated with smaller gray matter volume, lower activation, and decreased functional connectivity (FC). However, the effect of polygenic inheritance on the bra...

Although modified electroconvulsive therapy (ECT) has been reported to be effective for the treatment of schizophrenia (SCZ), its action mechanism is unclear. To elucidate the underlying ECT mechanisms of SCZ, this study used a longitudinal cohort including 21 SCZ patients receiving only antipsychotics (DSZ group) and 21 SCZ patients receiving a re...

Background: Positive reappraisal aims to reinterpret negative situations in a more positive light. Single-pulse transcranial magnetic stimulation (TMS) over the left ventrolateral prefrontal cortex (VLPFC) during positive reappraisal was suggested to improve emotion regulation capacity. However, it remains unclear whether the improvement of the cap...

Background Early identification and treatment of clinical high-risk for psychosis (CHRP) are critical to prevent the onset of psychosis, but there is no objective biomarker for CHR-P diagnosis. Methods Ninety medication naïve CHR-P subjects and eighty-six healthy controls (HCs) were recruited. The metabolic profiles of plasma samples were acquired...

Metacognition refers to the ability to be aware of one’s own cognition. Ample evidence indicates that metacognition in the human primate is highly dissociable from cognition, specialized across domains, and subserved by distinct neural substrates. However, these aspects remain relatively understudied in macaque monkeys. In the present study, we inv...

Metacognition refers to the ability to be aware of one's own cognition. Ample evidence indicate that metacognition in the human primate is highly dissociable from cognition, specialized across domains, and subserved by distinct neural substrates. However, these aspects remain relatively understudied in the macaque monkeys. Here we investigated the...

Reliable mapping of system-level individual differences is a critical first step towards precision medicine for complex disorders such as schizophrenia. Disrupted structural covariance indicates a system-level brain maturational disruption in schizophrenia. However, most studies examine structural covariance at the group-level. This prevents subjec...

Objectives We used eye-tracking to evaluate multiple facial context processing and event-related potential(ERP) to evaluate multiple facial recognition in individuals at clinical-high risk(CHR) for psychosis. Methods In total, 173 subjects(83 CHRs and 90 healthy controls[HCs]) were included and their emotion perception performances were accessed....

Background: Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT). However, reports on the use of MST for patients with schizophrenia, particularly in developing countries, which is a main indication for ECT, are limited. Methods: From February 2017 to July 2018, 79 inpatients who met the DSM-5 criteria for sc...

Prefrontal cortex (PFC) plays an important role in emotional processing and therefore is one of the most frequently targeted regions for non-invasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS) in clinical trials, especially in the treatment of emotional disorders. As an approach to enhance the effectiveness of rTM...

Background: This study examines whether cognitive insight is impaired in high-risk individuals with attenuated psychotic symptoms (APS) and explores the relationship between cognitive and clinical insight at different durations of untreated attenuated psychotic symptoms (DUAPS). Methods: The Structured Interview for Psychosis high-risk Syndrome (SI...

White matter abnormality has been widely reported in patients with schizophrenia (Sz). However, few studies have focused on the relationship between the white matter deficit and formal thought disorder (FTD). Moreover, the role of genetic high risk in FTD-related white matter deficit remains unclear. The present study recruited 46 Sz patients, 18 u...

Background Brain dynamics abnormalities in the triple-network, which involves the salience network (SN), the default mode network (DMN) and the central executive network (CEN), have been reported in schizophrenia. However, it remains to be clarified how antipsychotics affect dynamic functional connectivity (DFC) within the triple-network and whethe...

D-amino acid oxidase activator (DAOA) gene, which plays a crucial role in the process of glutamatergic transmission and mitochondrial function, is frequently linked with the liability for schizophrenia. We aimed to investigate whether the variation of DAOA rs2391191 is associated with alterations in white matter integrity of first-episode schizophr...

Individuals at clinical high risk (CHR) for psychosis exhibit a reduced P300 oddball response, which indicates deficits in attention and working memory processes. Previous studies have mainly researched these responses in the temporal domain; hence, non-phase-locked or induced neural activities may have been ignored. Event-related potential (ERP) a...

Cortical thickness reductions are evident in schizophrenia (SZ). Associations between antipsychotic medications (APMs) and cortical morphometry have been explored in SZ patients. This raises the question of whether the reconfiguration of morphological architecture by APM plays potential compensatory roles for abnormalities in the cerebral cortex. S...

BACKGROUND Few studies have examined the effects of age on neurocognition to predict conversion to psychosis in individuals with clinical high-risk(CHRs). This study aimed to compare the extent and predictive performance of cognitive deficits between adolescents and adults with CHR. METHODS A comprehensive neuropsychological battery was performed...

Advances in neuroimaging have promised the development of specific and objective biomarkers for the diagnosis and treatment of psychiatric disorders. Recently, functional near-infrared spectroscopy (fNIRS) has been used during cognitive tasks to measure cortical dysfunction associated with mental illnesses such as Schizophrenia (SCH), Major-Depress...

The lack of objective diagnostic markers has long been a challenge in the clinical management of schizophrenia (SZ). The current bivariate cut-offs method is an objective quantification of niacin skin flush abnormality (NFA) for identifying the SZ subgroup. However, the sensitivity of approximately 30% limits the application of NFA as a marker for...

Purpose This study investigated temporal dynamics in degree centrality (DC) of the brain functional connectome in first-episode schizophrenia with different short-term treatment responses. Methods A total of 127 first-episode patients (FEPs) with schizophrenia and 133 healthy controls (HCs) were recruited in this study. All subjects underwent rest...

Objective: The cerebellum serves a wide range of functions and is suggested to be composed of discrete regions dedicated to unique functions. We recently developed a new parcellation of the dentate nuclei (DN), the major output nuclei of the cerebellum, which optimally divides the structure into 3 functional territories that contribute uniquely to...

Mismatch negativity (MMN) is an intensively studied event-related potential component that reflects pre-attentive auditory processing. Existing spatial MMN (sMMN) studies usually use loud-speakers in different locations or deliver sound with binaural localization cues through earphones to elicit MMN, which either was practically complicated or soun...

Hippocampal volume loss is prominent in first episode schizophrenia (FES) and has been associated with poor clinical outcomes and with BDNF genotype; antidepressants are believed to reverse hippocampal volume loss via release of BDNF. In a 12-month, placebo-controlled add-on trial of the antidepressant, citalopram, during the maintenance phase of F...

Purpose/background: Hippocampal volume loss in early schizophrenia has been linked with markers of inflammation and oxidative stress, and with less response of negative symptoms. Aripiprazole has been reported to preserve hippocampal volume and to reduce inflammation. Methods/procedures: Study 1 was a 12-month multicenter randomized placebo-cont...

Neuroimage studies have yielded evidence for a correlation between the left ventrolateral prefrontal cortex (VLPFC) and a specific type of cognitive reappraisal strategy, positive reappraisal. However, evidence is still lacking for a direct relation. We used single-pulse transcranial magnetic stimulation (TMS) over the left VLPFC at different time...

Objective: The cerebellum serves a wide range of functions and is suggested to be composed of discrete regions dedicated to unique functions. We recently developed a new parcellation of the dentate nuclei (DN), the major output nuclei of the cerebellum, which optimally divides the structure into three functional territories that contribute uniquely...

Negative symptoms are the major challenge in clinical management of schizophrenia. Dorsomedial prefrontal cortex (DMPFC) has been suggested to be highly involved in the mechanisms of negative symptoms of schizophrenia. However, the effect of repetitive Transcranial Magnetic Stimulation (rTMS) over DMPFC has not yet been well studied. In this double...

Background Antipsychotics are widely used for treating patients with psychosis, and target threshold psychotic symptoms. Individuals at clinical high risk (CHR) for psychosis are characterized by subthreshold psychotic symptoms. It is currently unclear who might benefit from antipsychotic treatment. Our objective was to apply a risk calculator (RC)...