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Comparing language lateralization in psychotic mania and psychotic depression to schizophrenia; A functional MRI study

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Acknowledgment

This research project was sponsored by a NARSAD young investigator award.

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    This is consistent with the results described in previous studies using the DL procedure, showing that - compared to normal controls - psychotic bipolar patients failed to show the normal right-ear (left-hemisphere) advantage (Bruder et al., 1995; Kaprinis et al., 1995; Najt and Hausmann, 2014). This reduction in right-ear advantage in bipolar patients has been related to left temporal lobe dysfunction associated with psychotic symptoms such as auditory hallucinations as opposed to the affective manifestations of mania (Kaprinis et al., 1995; Sommer, 2007; Bozikas et al., 2008). Current literature suggests that AVHs may reflect a disruption of cortico-cortical connectivity between areas concerned with normal speech perception.

  • Reduced language lateralization in first episode schizophrenia: A near infrared spectroscopy study

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    In a meta-analysis, Ocklenburg et al. (2013) concluded that reduced language lateralization is a strong trait marker for the experience of auditory hallucinations in patients with SZ. However, other studies have failed to find a correlation between reduced language lateralization and psychotic symptoms (Bleich-Cohen et al., 2009; Razafimandimby et al., 2007; Sommer et al., 2007; van Veelen et al., 2011). So far, most neuroimaging studies focusing on language lateralization have been carried out in patients with chronic SZ.

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    To address such issues, previous imaging studies have employed a dimensional approach, by examining the neurobiology of specific symptoms crossing diagnostic boundaries. These have included individuals with, or at increased risk of, schizophrenia with and without mood symptoms (Whalley et al., 2008; Simon et al., 2010; Tomasino et al., 2011; Barbour et al., 2012), and patients with mood disorder with and without psychotic features (Sommer et al., 2007; Khadka et al., 2013). Although literature is limited, evidence suggests alterations in medial temporal lobe and limbic structures in association with mood-related symptoms across disorders (Tomasino et al., 2011), and alterations in lateral prefrontal functioning in association with psychosis, also trans-diagnostically (Anticevic et al., 2013).

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    Typically, the left hemisphere controls the processing of language (Galaburda and Geschwind, 1981; Springer et al., 1999; Frost et al., 1999) and the dexterity of the right hand (Steele, 2000; Annett, 2002). Various disorders are associated with reduced lateralization to the left side of the brain, such as autism (Minagawa-Kawai et al., 2009; Kleinhans et al., 2008), dyslexia (Spironelli et al., 2008), unipolar and bipolar affective psychosis (Sommer et al., 2007) and schizophrenia (Shenton et al., 2001; Sommer et al., 2001). In schizophrenia, reduced functional lateralization is evidenced by an excess of mixed-handedness (Orr et al., 1999; Sommer et al., 2001; Collinson et al., 2004) (although this was not confirmed in a recent study byDeep-Soboslay et al. (2010)) and reduced language lateralization (Li et al., 2007; Sommer et al., 2001, 2004; Dollfus et al., 2005; Spaniel et al., 2007; Razafimandimby et al., 2007; Sakuma et al., 1996; Li et al., 2009).

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    Psychiatric disorders, such as autism, Attention Deficit Hyperactivity Disorder (ADHD) and schizophrenia all have higher prevalences in males as compared to females (reviewed by Afifi, 2007). These psychiatric disorders may be associated with deviations in standard cerebral dominance (Bradshaw and Sheppard 2000; Sommer et al., 2007). Finally, women appear to recover better from aphasia than males after left cerebral stroke (Pedersen et al., 1995).

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