Bio

Academic Appointments


Honors & Awards


  • David Mahoney Neuroimaging Award, The Dana Foundation (5/1/14-4/30/17)
  • NARSAD Young Investigator Award, Brain & Behavioral Research Foundation (7/1/11-6/30/13)

Professional Education


  • BA, Swarthmore College, Sociology/Anthropology (1990)
  • MD, New York University School of Medicine (1995)
  • Internship, University of California San Francisco (1996)
  • Residency, University of California San Francisco, Psychiatry (1999)
  • Board Certification, American Board of Psychiatry and Neurology, Psychiatry (1999)
  • Post-Doctoral Fellowship, University of California Berkeley, Cognitive Neuroscience/Functional Neuroimaging (2005)

Teaching

2013-14 Courses


Publications

Journal Articles


  • Disrupted action monitoring in recent-onset psychosis patients with schizophrenia and bipolar disorder PSYCHIATRY RESEARCH-NEUROIMAGING Minzenberg, M. J., Gomes, G. C., Yoon, J. H., Swaab, T. Y., Carter, C. S. 2014; 221 (1): 114-121

    Abstract

    Schizophrenia patients experience cognitive control disturbances, manifest in altered neural signatures during action monitoring. It remains unclear whether error- and conflict-monitoring disturbances co-occur, and whether they are observed in recent-onset psychosis patients with schizophrenia or bipolar disorder. We tested electrophysiological measures of action monitoring in these patients. Seventy-three schizophrenia patients (SZ), 26 bipolar disorder type I patients (BP), each within one year of psychosis onset, and 54 healthy control subjects (HC) underwent EEG during Stroop task performance. In the trial-averaged EEG at three midline scalp electrodes, the error-related negativity (ERN), error positivity (Pe) and conflict-related N450 were measured. Compared to HC (1) SZ exhibited an attenuated ERN and N450, and Pe unchanged and (2) BP exhibited an attenuated ERN but normal Pe and N450. Between patient groups, SZ showed an attenuated N450; ERN and Pe were not significantly different. A small (n=10) SZ subgroup that was not receiving antipsychotic medication showed normal ERPs. Altered error- and conflict-monitoring occur together in the first-episode schizophrenia patients, and these measures are comparable in patients with the first-episode bipolar disorder. Antipsychotic medication may be associated with altered measures of error-monitoring in schizophrenia.

    View details for DOI 10.1016/j.pscychresns.2013.11.003

    View details for Web of Science ID 000329459300017

    View details for PubMedID 24314907

  • Impaired context processing as a potential marker of psychosis risk state PSYCHIATRY RESEARCH-NEUROIMAGING Niendam, T. A., Lesh, T. A., Yoon, J., Westphal, A. J., Hutchison, N., Ragland, J. D., Solomon, M., Minzenberg, M., Carter, C. S. 2014; 221 (1): 13-20
  • Impaired Prefrontal-Basal Ganglia Functional Connectivity and Substantia Nigra Hyperactivity in Schizophrenia BIOLOGICAL PSYCHIATRY Yoon, J. H., Minzenberg, M. J., Raouf, S., D'Esposito, M., Carter, C. S. 2013; 74 (2): 122-129

    Abstract

    The theory that prefrontal cortex (PFC) dysfunction in schizophrenia leads to excess subcortical dopamine has generated widespread interest because it provides a parsimonious account for two core features of schizophrenia, cognitive deficits and psychosis, respectively. However, there has been limited empirical validation of this model. Moreover, the identity of the specific subcortical brain regions and circuits that may be impaired as a result of PFC dysfunction and mediate its link to psychosis in schizophrenia remains unclear. We undertook this event-related functional magnetic resonance imaging study to test the hypothesis that PFC dysfunction is associated with altered function of and connectivity with dopamine regulating regions of the basal ganglia.Eighteen individuals with schizophrenia or schizoaffective disorder and 19 healthy control participants completed event-related functional magnetic resonance imaging during working memory. We conducted between-group contrasts of task-evoked, univariate activation maps to identify regions of altered function in schizophrenia. We also compared the groups on the level of functional connectivity between a priori identified PFC and basal ganglia regions to determine if prefrontal disconnectivity in patients was present.We observed task-evoked hyperactivity of the substantia nigra that occurred in association with prefrontal and striatal hypoactivity in the schizophrenia group. The magnitude of prefrontal functional connectivity with these dysfunctional basal ganglia regions was decreased in the schizophrenia group. Additionally, the level of nigrostriatal functional connectivity predicted the level of psychosis.These results suggest that functional impairments of the prefrontal striatonigral circuit may be a common pathway linking the pathogenesis of cognitive deficits and psychosis in schizophrenia.

    View details for DOI 10.1016/j.biopsych.2012.11.018

    View details for Web of Science ID 000321108800009

    View details for PubMedID 23290498

  • Semantic processes leading to true and false memory formation in schizophrenia SCHIZOPHRENIA RESEARCH Paz-Alonso, P. M., Ghetti, S., Ramsay, I., Solomon, M., Yoon, J., Carter, C. S., Ragland, J. D. 2013; 147 (2-3): 320-325

    Abstract

    Encoding semantic relationships between items on word lists (semantic processing) enhances true memories, but also increases memory distortions. Episodic memory impairments in schizophrenia (SZ) are strongly driven by failures to process semantic relations, but the exact nature of these relational semantic processing deficits is not well understood. Here, we used a false memory paradigm to investigate the impact of implicit and explicit semantic processing manipulations on episodic memory in SZ. Thirty SZ and 30 demographically matched healthy controls (HC) studied Deese/Roediger-McDermott (DRM) lists of semantically associated words. Half of the lists had strong implicit semantic associations and the remainder had low strength associations. Similarly, half of the lists were presented under "standard" instructions and the other half under explicit "relational processing" instructions. After study, participants performed recall and old/new recognition tests composed of targets, critical lures, and unrelated lures. HC exhibited higher true memories and better discriminability between true and false memory compared to SZ. High, versus low, associative strength increased false memory rates in both groups. However, explicit "relational processing" instructions positively improved true memory rates only in HC. Finally, true and false memory rates were associated with severity of disorganized and negative symptoms in SZ. These results suggest that reduced processing of semantic relationships during encoding in SZ may stem from an inability to implement explicit relational processing strategies rather than a fundamental deficit in the implicit activation and retrieval of word meanings from patients' semantic lexicon.

    View details for DOI 10.1016/j.schres.2013.04.007

    View details for Web of Science ID 000320598700017

    View details for PubMedID 23623175

  • Abnormal Activity-Dependent Brain Lactate and Glutamate plus Glutamine Responses in Panic Disorder BIOLOGICAL PSYCHIATRY Maddock, R. J., Buonocore, M. H., Miller, A. R., Yoon, J. H., Soosman, S. K., Unruh, A. M. 2013; 73 (11): 1111-1119

    Abstract

    Prior evidence suggests panic disorder (PD) is characterized by neurometabolic abnormalities, including increased brain lactate responses to neural activation. Increased lactate responses could reflect a general upregulation of metabolic responses to neural activation. However, prior studies in PD have not measured activity-dependent changes in brain metabolites other than lactate. Here we examine activity-dependent changes in both lactate and glutamate plus glutamine (glx) in PD.Twenty-one PD patients (13 remitted, 8 symptomatic) and 12 healthy volunteers were studied. A single-voxel, J-difference, magnetic resonance spectroscopy editing sequence was used to measure lactate and glx changes in visual cortex induced by visual stimulation.The PD patients had significantly greater activity-dependent increases in brain lactate than healthy volunteers. The differences were significant for both remitted and symptomatic PD patients, who did not differ from each other. Activity-dependent changes in glx were significantly smaller in PD patients than in healthy volunteers. The temporal correlation between lactate and glx changes was significantly stronger in control subjects than in PD patients.The novel demonstration that glx responses are diminished and temporally decoupled from lactate responses in PD contradicts the model of a general upregulation of activity-dependent brain metabolic responses in PD. The increase in activity-dependent brain lactate accumulation appears to be a trait feature of PD. Given the close relationship between lactate and pH in the brain, the findings are consistent with a model of brain metabolic and pH dysregulation associated with altered function of acid-sensitive fear circuits contributing to trait vulnerability in PD.

    View details for DOI 10.1016/j.biopsych.2012.12.015

    View details for Web of Science ID 000318997000013

    View details for PubMedID 23332354

  • Oxytocin and Vasopressin in Children and Adolescents With Autism Spectrum Disorders: Sex Differences and Associations With Symptoms AUTISM RESEARCH Miller, M., Bales, K. L., Taylor, S. L., Yoon, J., Hostetler, C. M., Carter, C. S., Solomon, M. 2013; 6 (2): 91-102

    Abstract

    There has been intensified interest in the neuropeptides oxytocin (OT) and arginine vasopressin (AVP) in autism spectrum disorders (ASD) given their role in affiliative and social behavior in animals, positive results of treatment studies using OT, and findings that genetic polymorphisms in the AVP-OT pathway are present in individuals with ASD. Nearly all such studies in humans have focused only on males. With this preliminary study, we provide basic and novel information on the involvement of OT and AVP in autism, with an investigation of blood plasma levels of these neuropeptides in 75 preadolescent and adolescent girls and boys ages 8-18: 40 with high-functioning ASD (19 girls, 21 boys) and 35 typically developing children (16 girls, 19 boys). We related neuropeptide levels to social, language, repetitive behavior, and internalizing symptom measures in these individuals. There were significant gender effects: Girls showed higher levels of OT, while boys had significantly higher levels of AVP. There were no significant effects of diagnosis on OT or AVP. Higher OT values were associated with greater anxiety in all girls, and with better pragmatic language in all boys and girls. AVP levels were positively associated with restricted and repetitive behaviors in girls with ASD but negatively (nonsignificantly) associated with these behaviors in boys with ASD. Our results challenge the prevailing view that plasma OT levels are lower in individuals with ASD, and suggest that there are distinct and sexually dimorphic mechanisms of action for OT and AVP underlying anxiety and repetitive behaviors. Autism Res 2013, 6: 91-102. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.

    View details for DOI 10.1002/aur.1270

    View details for Web of Science ID 000318117500003

    View details for PubMedID 23413037

  • Windows to the soul: vision science as a tool for studying biological mechanisms of information processing deficits in schizophrenia Frontiers in Psychology Yoon, J. H., Sheremata, S. L., Rokem, A., Silver, M. A. 2013

    View details for DOI 10.3389/fpsyg.2013.00681

  • Proactive and reactive cognitive control and dorsolateral prefrontal cortex dysfunction in first episode schizophrenia. NeuroImage. Clinical Lesh, T. A., Westphal, A. J., Niendam, T. A., Yoon, J. H., Minzenberg, M. J., Ragland, J. D., Solomon, M., Carter, C. S. 2013; 2: 590-599

    Abstract

    Cognitive control deficits have been consistently documented in patients with schizophrenia. Recent work in cognitive neuroscience has hypothesized a distinction between two theoretically separable modes of cognitive control-reactive and proactive. However, it remains unclear the extent to which these processes are uniquely associated with dysfunctional neural recruitment in individuals with schizophrenia. This functional magnetic resonance imaging (fMRI) study utilized the color word Stroop task and AX Continuous Performance Task (AX-CPT) to tap reactive and proactive control processes, respectively, in a sample of 54 healthy controls and 43 patients with first episode schizophrenia. Healthy controls demonstrated robust dorsolateral prefrontal, anterior cingulate, and parietal cortex activity on both tasks. In contrast, patients with schizophrenia did not show any significant activation during proactive control, while showing activation similar to control subjects during reactive control. Critically, an interaction analysis showed that the degree to which prefrontal activity was reduced in patients versus controls depended on the type of control process engaged. Controls showed increased dorsolateral prefrontal cortex (DLPFC) and parietal activity in the proactive compared to the reactive control task, whereas patients with schizophrenia did not demonstrate this increase. Additionally, patients' DLPFC activity and performance during proactive control was associated with disorganization symptoms, while no reactive control measures showed this association. Proactive control processes and concomitant dysfunctional recruitment of DLPFC represent robust features of schizophrenia that are also directly associated with symptoms of disorganization.

    View details for DOI 10.1016/j.nicl.2013.04.010

    View details for PubMedID 24179809

  • Excessive contralateral motor overflow in schizophrenia measured by fMRI PSYCHIATRY RESEARCH-NEUROIMAGING Minzenberg, M. J., Yoon, J. H., Soosman, S. K., Carter, C. S. 2012; 202 (1): 38-45

    Abstract

    Schizophrenia is characterized by significant problems in control of behavior; however, the disturbances in neural systems that control movement remain poorly characterized. We used functional magnetic resonance imaging (fMRI) to evaluate the origin of motor overflow in schizophrenia. Twenty-seven clinically stable medicated outpatients with Diagnostic and Statistical Manual, 4th edition, text revision (DSM-IV-TR)-defined schizophrenia (SZ), and 18 healthy control (HC) subjects, all right-handed, performed a dominant-handed, single-choice visual sensorimotor reaction time paradigm during fMRI. Voxel-wise analyses were conducted within sensorimotor cortical and striatal regions on general linear model (GLM)-derived measures of blood oxygen level-dependent (BOLD) signal change. The SZ group was not different from the HC group in reaction time, activation in somatosensory or motor cortices ipsilateral to the active (intended) descending corticospinal tract, nor visual cortex. However, in the right hemisphere (contralateral to the active M1), the SZ group showed significantly higher activation in primary motor cortex and adjacent premotor and somatosensory cortices (right Brodmann areas (BA) 1 through 4, and 6), and significantly lower activation in bilateral basal ganglia. Right BA 4 activation was strongly related to disorganization and poverty symptoms (and unrelated to medications) in the patient group. This study provides evidence in SZ of excessive neural activity in motor cortex contralateral to the intended primary motor cortex, which may form the basis for altered motor laterality and motor overflow previously observed, and disorganized behavior. This pathological motor overflow may be partly due to altered modulation of intended movement within the basal ganglia and premotor cortex.

    View details for DOI 10.1016/j.pscychresns.2012.03.005

    View details for Web of Science ID 000306622400005

    View details for PubMedID 22608155

  • Automated classification of fMRI during cognitive control identifies more severely disorganized subjects with schizophrenia SCHIZOPHRENIA RESEARCH Yoon, J. H., Nguyen, D. V., McVay, L. M., Deramo, P., Minzenberg, M. J., Ragland, J. D., Niendham, T., Solomon, M., Carter, C. S. 2012; 135 (1-3): 28-33

    Abstract

    The establishment of a neurobiologically based nosological system is one of the ultimate goals of modern biological psychiatry research. Developments in neuroimaging and statistical/machine learning have provided useful basic tools for these efforts. Recent studies have demonstrated the utility of fMRI as input data for the classification of schizophrenia, but none, to date, has used fMRI of cognitive control for this purpose. In this study, we evaluated the accuracy of an unbiased classification method on fMRI data from a large cohort of subjects with first episode schizophrenia and a cohort of age matched healthy control subjects while they completed the AX version of the Continuous Performance Task (AX-CPT). We compared these results to classifications based on AX-CPT behavioral data. Classification accuracy for DSM-IV defined schizophrenia using fMRI data was modest and comparable to classifications conducted with behavioral data. Interestingly fMRI classifications did however identify a distinct subgroup of patients with greater behavioral disorganization, whereas behavioral data classifications did not. These results suggest that fMRI-based classification could be a useful tool in defining a neurobiologically distinct subgroup within the clinically defined syndrome of schizophrenia, reflecting alterations in discrete neural circuits. Independent validation of classification-based phenotypes using other biological data such as genetics would provide a strong test of this hypothesis.

    View details for DOI 10.1016/j.schres.2012.01.001

    View details for Web of Science ID 000300940000005

    View details for PubMedID 22277668

  • Neural correlates of relational and item-specific encoding during working and long-term memory in schizophrenia NEUROIMAGE Ragland, J. D., Blumenfeld, R. S., Ramsay, I. S., Yonelinas, A., Yoon, J., Solomon, M., Carter, C. S., Ranganath, C. 2012; 59 (2): 1719-1726

    Abstract

    Successful long-term memory (LTM) depends upon effective control of information in working memory (WM), and there is evidence that both WM and LTM are impaired by schizophrenia. This study tests the hypothesis that LTM deficits in schizophrenia may result from impaired control of relational processing in WM due to dorsolateral prefrontal cortex (DLPFC) dysfunction. fMRI was performed on 19 healthy controls and 20 patients with schizophrenia during WM tasks emphasizing relational (reorder trials) versus item-specific (rehearse trials) processing. WM activity was also examined with respect to LTM recognition on a task administered outside the scanner. Receiver operator characteristic analysis assessed familiarity and recollection components of LTM. Patients showed a disproportionate familiarity deficit for reorder versus rehearse trials against a background of generalized LTM impairments. Relational processing during WM led to DLPFC activation in both groups. However, this activation was less focal in patients than in controls, and patients with more severe negative symptoms showed less of a DLPFC increase. fMRI analysis of subsequent recognition performance revealed a group by condition interaction. High LTM for reorder versus rehearse trials was associated with bilateral DLPFC activation in controls, but not in patients who activated the left middle temporal and inferior occipital gyrus. Results indicate that although patients can activate the DLPFC on a structured relational WM task, this activation is less focal and does not translate to high retrieval success, suggesting a disruption in the interaction between WM and LTM processes in schizophrenia.

    View details for DOI 10.1016/j.neuroimage.2011.08.055

    View details for Web of Science ID 000298210600094

    View details for PubMedID 21907293

  • Broader visual orientation tuning in patients with schizophrenia FRONTIERS IN HUMAN NEUROSCIENCE Rokem, A., Yoon, J. H., Ooms, R. E., Maddock, R. J., Minzenberg, M. J., Silver, M. A. 2011; 5

    Abstract

    Reduced gamma-aminobutyric acid (GABA) levels in cerebral cortex are thought to contribute to information processing deficits in patients with schizophrenia (SZ), and we have previously reported lower in vivo GABA levels in the visual cortex of patients with SZ. GABA-mediated inhibition plays a role in sharpening orientation tuning of visual cortical neurons. Therefore, we predicted that tuning for visual stimulus orientation would be wider in SZ. We measured orientation tuning with a psychophysical procedure in which subjects performed a target detection task of a low-contrast oriented grating, following adaptation to a high-contrast grating. Contrast detection thresholds were determined for a range of adapter-target orientation offsets. For both SZ and healthy controls, contrast thresholds decreased as orientation offset increased, suggesting that this tuning curve reflects the selectivity of visual cortical neurons for stimulus orientation. After accounting for generalized deficits in task performance in SZ, there was no difference between patients and controls for detection of target stimuli having either the same orientation as the adapter or orientations far from the adapter. However, patients' thresholds were significantly higher for intermediate adapter-target offsets. In addition, the mean width parameter of a Gaussian fit to the psychophysical orientation tuning curves was significantly larger for the patient group. We also present preliminary data relating visual cortical GABA levels, as measured with magnetic resonance spectroscopy, and orientation tuning width. These results suggest that our finding of broader orientation tuning in SZ may be due to diminished visual cortical GABA levels.

    View details for DOI 10.3389/fnhum.2011.00127

    View details for Web of Science ID 000297940400001

    View details for PubMedID 22069385

  • From lumping to splitting and back again: Atypical social and language development in individuals with clinical-high-risk for psychosis, first episode schizophrenia, and autism spectrum disorders SCHIZOPHRENIA RESEARCH Solomon, M., Olsen, E., Niendam, T., Ragland, J. D., Yoon, J., Minzenberg, M., Carter, C. S. 2011; 131 (1-3): 146-151

    Abstract

    Individuals with autism and schizophrenia exhibit atypical language and social symptoms. The extent to which these symptoms are evident during development and in current functioning is unclear.Three groups of patients aged 11-20 diagnosed as clinical-high-risk for psychosis (CHR; n=15), first episode psychosis (FEP; n=16), and autism spectrum disorders (ASD; n=20), plus typically developing individuals (TYP; n=20) were compared on common autism parent-report questionnaires assessing social and language development and current functioning including the Social Communication Questionnaire, the Children's Communication Checklist, and the Social Reciprocity Scale.All clinical groups demonstrated atypical social and language development, with social impairment highest in ASD. Twenty percent of participants with CHR and FEP met diagnostic criteria for ASD as assessed by parent-report. ASD exhibited greater current syntactic, and pragmatic language symptoms including delayed echolalia, pedantic speech, and deficits in appreciating irony and sarcasm. All clinical groups exhibited current deficits in social functioning. CHR and FE had similar and intermediate levels of functioning relative to ASD and TYP, with CHR generally scoring closer to TYP, providing construct validity for the CHR diagnostic label.The results of this study suggest that ASDs, CHR, and FEP share common features of atypical neurodevelopment of language and social function. Evidence of impaired social reciprocity across both disorders and distinct language symptoms in ASDs provides important information for differential diagnosis and psychosis prevention, as well as leads for future investigations of comparative genetics and pathophysiology.

    View details for DOI 10.1016/j.schres.2011.03.005

    View details for Web of Science ID 000295111400024

    View details for PubMedID 21458242

  • General and Specific Functional Connectivity Disturbances in First-Episode Schizophrenia During Cognitive Control Performance BIOLOGICAL PSYCHIATRY Fornito, A., Yoon, J., Zalesky, A., Bullmore, E. T., Carter, C. S. 2011; 70 (1): 64-72

    Abstract

    Cognitive control impairments in schizophrenia are thought to arise from dysfunction of interconnected networks of brain regions, but interrogating the functional dynamics of large-scale brain networks during cognitive task performance has proved difficult. We used functional magnetic resonance imaging to generate event-related whole-brain functional connectivity networks in participants with first-episode schizophrenia and healthy control subjects performing a cognitive control task.Functional connectivity during cognitive control performance was assessed between each pair of 78 brain regions in 23 patients and 25 control subjects. Network properties examined were region-wise connectivity, edge-wise connectivity, global path length, clustering, small-worldness, global efficiency, and local efficiency.Patients showed widespread functional connectivity deficits in a large-scale network of brain regions, which primarily affected connectivity between frontal cortex and posterior regions and occurred irrespective of task context. A more circumscribed and task-specific connectivity impairment in frontoparietal systems related to cognitive control was also apparent. Global properties of network topology in patients were relatively intact.The first episode of schizophrenia is associated with a generalized connectivity impairment affecting most brain regions but that is particularly pronounced for frontal cortex. Superimposed on this generalized deficit, patients show more specific cognitive-control-related functional connectivity reductions in frontoparietal regions. These connectivity deficits occur in the context of relatively preserved global network organization.

    View details for DOI 10.1016/j.biopsych.2011.02.019

    View details for Web of Science ID 000291559300013

    View details for PubMedID 21514570

  • Modafinil modulation of the default mode network PSYCHOPHARMACOLOGY Minzenberg, M. J., Yoon, J. H., Carter, C. S. 2011; 215 (1): 23-31

    Abstract

    The default mode network (DMN) is a functional network which is implicated in a range of cognitive processes. This network is proposed to consist of hubs located in the ventromedial prefrontal cortex (vmPFC), posterior cingulate/retrosplenial cortex (PCC/rSpl), and inferior parietal lobule (IPL), with other midline cortical and temporal lobe nodes connected to these hubs. How this network is modulated by neurochemical systems during functional brain activity is not yet understood.In the present study, we used the norepinephrine/dopamine transporter inhibitor modafinil to test the hypothesis that this drug modulates the DMN.Eighteen healthy right-handed adults participated in a double-blind, placebo-controlled study of single oral dose modafinil 200 mg. They performed a simple visual sensorimotor task during slow event-related fMRI. Drug effects were interrogated within the DMN defined by task-induced deactivation (TID) on placebo.There was a trend toward faster reaction time (RT) on modafinil (Cohen's d = 0.38). Brain regions within the DMN which exhibited significant modafinil-induced augmentation of TID included vmPFC, PCC/rSpl, and left IPL. Across subjects, the modafinil effect on TID in the vmPFC was significantly and specifically associated with drug effects on RT speeding.Modafinil augments TID in the DMN to facilitate sensorimotor processing speed, an effect which may be particularly dependent on changes in vmPFC activity. This is consistent with the gain control function of catecholamine systems and may represent an important aspect of the pro-cognitive effects of modafinil.

    View details for DOI 10.1007/s00213-010-2111-5

    View details for Web of Science ID 000289293000003

    View details for PubMedID 21153806

  • Prefrontal Cortical Deficits and Impaired Cognition-Emotion Interactions in Schizophrenia AMERICAN JOURNAL OF PSYCHIATRY Ursu, S., Kring, A. M., Gard, M. G., Minzenberg, M. J., Yoon, J. H., Ragland, J. D., Solomon, M., Carter, C. S. 2011; 168 (3): 276-285

    Abstract

    Despite schizophrenia patients' reports of diminished experience of emotion in interviews and self-report measures, their emotional experience in the presence of emotional stimuli and in daily life ("in the moment") appears largely intact. To examine emotion-cognition interactions, the authors tested the hypothesis that schizophrenia patients have unimpaired in-the-moment emotional reactivity but have a deficit in prefrontal cortical mechanisms needed to maintain and report on experience following exposure to emotional stimuli.Using a slow event-related functional MRI paradigm, the authors examined the brain activity of 23 schizophrenia patients and 24 healthy comparison subjects during trials in which they viewed an affective picture and, after a delay, reported their emotional experience while viewing it.The patients' self-reports of emotional experience differed from those of the healthy subjects when they rated their experience on dimensions inconsistent with the stimulus valence but not when the dimension was consistent with it. In the presence of emotional stimuli, brain activity in the patients was similar to that of the comparison subjects. During the delay, however, patients showed decreased activation in a network of brain structures, including the dorsolateral prefrontal cortex and other prefrontal, limbic, and paralimbic areas. In patients, the delay-related response of the dorsolateral prefrontal cortex to pleasant stimuli correlated negatively with an anhedonia measure.These results suggest that schizophrenia is characterized by a failure of prefrontal circuitry supporting the link between emotion and goal-directed behavior and that the failure of this mechanism may contribute to deficits in processes related to emotion-cognition interaction.

    View details for DOI 10.1176/appi.ajp.2010.09081215

    View details for Web of Science ID 000287916900011

    View details for PubMedID 21205806

  • An Index of Relative Central alpha-Adrenergic Receptor Antagonism by Antipsychotic Medications EXPERIMENTAL AND CLINICAL PSYCHOPHARMACOLOGY Minzenberg, M. J., Yoon, J. H. 2011; 19 (1): 31-39

    Abstract

    Antipsychotic medications exert variable and clinically significant levels of antagonism at central α-adrenergic receptors. To evaluate the impact of this activity on both clinical and experimental measures, an index estimating the relative activity of these medications is needed. We comprehensively searched the empirical literature testing in vitro binding to mammalian brain α-adrenergic receptors of all antipsychotic medications available for clinical use in the United States as of August 2010 and created a quantitative summary index of the potency of binding to α receptors relative to haloperidol (HALα1 and HALα2 equivalents). The potency of binding at α1- and α2-adrenergic receptors varies widely among these medications, with a 532-fold range for α1 antagonism and a 400-fold range for α2 antagonism among atypical antipsychotics. There is considerable overlap between atypical and typical antipsychotic medication groups on each of these measures. This index of HALα equivalents should facilitate the determination of the effects of α-adrenergic antagonism by these medications on clinical efficacy, side effects, and biological and cognitive measures of illness and treatment.

    View details for DOI 10.1037/a0022258

    View details for Web of Science ID 000287466000004

    View details for PubMedID 21341921

  • Broader orientation tuning in patients with schizophrenia Frontiers in Human Neuroscience Rokem, A. S., Yoon, J. H., Ooms, R. E., Maddock, R. J., Minzenberg, M. J., Carter, C. S. 2011
  • Gamma Oscillatory Power is Impaired During Cognitive Control Independent of Medication Status in First-Episode Schizophrenia NEUROPSYCHOPHARMACOLOGY Minzenberg, M. J., Firl, A. J., Yoon, J. H., Gomes, G. C., Reinking, C., Carter, C. S. 2010; 35 (13): 2590-2599

    Abstract

    Schizophrenia is characterized by impaired cognitive control associated with prefrontal cortex dysfunction, but the underlying pathophysiological mechanisms remain unknown. Higher cognitive processes are associated with cortical oscillations in the gamma range, which are also impaired in chronic schizophrenia. We tested whether cognitive control-related gamma deficits are observed in first-episode patients, and whether they are associated with antipsychotic medication exposure. Fifty-three first-episode schizophrenia patients (21 without antipsychotic medication treatment) and 29 healthy control subjects underwent electroencephalography (EEG) during performance of a preparatory cognitive control task (preparing to overcome prepotency or POP task). The first-episode schizophrenia patient group was impaired (relative to the control group) on task performance and on delay-period gamma power at each of the three subgroups of frontal electrodes. The unmedicated patient subgroup was similarly impaired compared with controls, and was not different on these measures compared with the medicated patient subgroup. In contrast, delay-period theta power was not impaired in the full patient group nor in the unmedicated patient subgroup. Impaired cognitive control-related gamma cortical oscillatory activity is present at the first psychotic episode in schizophrenia, and is independent of medication status. This suggests that altered local circuit function supporting high-frequency oscillatory activity in prefrontal cortex ensembles may serve as the pathophysiological substrate of cognitive control deficits in schizophrenia.

    View details for DOI 10.1038/npp.2010.150

    View details for Web of Science ID 000284104400011

    View details for PubMedID 20827271

  • Use of Eye Movement Monitoring to Examine Item and Relational Memory in Schizophrenia BIOLOGICAL PSYCHIATRY Hannula, D. E., Ranganath, C., Ramsay, I. S., Solomon, M., Yoon, J., Niendam, T. A., Carter, C. S., Ragland, J. D. 2010; 68 (7): 610-616

    Abstract

    Patients with schizophrenia may be impaired at remembering interitem and item-context relationships (relational memory), even when memory for items is intact. Here, we applied the novel approach of using eye movements to assess integrity of item and relational memory in schizophrenia. This method does not rely on introspection and may be more readily translated to animal models than traditional behavioral methods.Sixteen healthy control subjects and 16 patients were administered a scene memory task while eye movements were monitored. During testing, participants indicated whether the scenes were unchanged, contained a new item (item manipulation), had a change in item location (relational manipulation), or were new. It was predicted that memory would be disproportionately impaired when relational changes were made.Results confirmed that tasks were equally difficult and showed that patients were impaired identifying all scene types. These behavioral impairments were associated with more severe disorganization and negative symptoms. Eye movement results were more specific. Both groups looked disproportionately at critical regions of repeated versus novel scenes-an effect of scene repetition. However, in contrast with predictions, patients showed equivalent eye-movement-based memory impairment whether changes were relational or item-based.This is the first experiment to demonstrate that eye movements can be used to investigate item and relational memory in schizophrenia. The eye movement procedure was well tolerated and was more specific than behavioral measures with respect to memory impairment. Results suggest that eye movements may be of use in clinical trials and translational studies employing animal models.

    View details for DOI 10.1016/j.biopsych.2010.06.001

    View details for Web of Science ID 000282356900005

    View details for PubMedID 20673874

  • Response to Comment on "Modafinil Shifts Human Locus Coeruleus to Low-Tonic, High-Phasic Activity During Functional MRI" SCIENCE Minzenberg, M. J., Watrous, A. J., Yoon, J. H., La, C., Ursu, S., Carter, C. S. 2010; 328 (5976)
  • GABA Concentration Is Reduced in Visual Cortex in Schizophrenia and Correlates with Orientation-Specific Surround Suppression JOURNAL OF NEUROSCIENCE Yoon, J. H., Maddock, R. J., Rokem, A., Silver, M. A., Minzenberg, M. J., Ragland, J. D., Carter, C. S. 2010; 30 (10): 3777-3781

    Abstract

    The neural mechanisms underlying cognitive deficits in schizophrenia remain essentially unknown. The GABA hypothesis proposes that reduced neuronal GABA concentration and neurotransmission results in cognitive impairments in schizophrenia. However, few in vivo studies have directly examined this hypothesis. We used magnetic resonance spectroscopy (MRS) at high field to measure visual cortical GABA levels in 13 subjects with schizophrenia and 13 demographically matched healthy control subjects. We found that the schizophrenia group had an approximately 10% reduction in GABA concentration. We further tested the GABA hypothesis by examining the relationship between visual cortical GABA levels and orientation-specific surround suppression (OSSS), a behavioral measure of visual inhibition thought to be dependent on GABAergic synaptic transmission. Previous work has shown that subjects with schizophrenia exhibit reduced OSSS of contrast discrimination (Yoon et al., 2009). For subjects with both MRS and OSSS data (n = 16), we found a highly significant positive correlation (r = 0.76) between these variables. GABA concentration was not correlated with overall contrast discrimination performance for stimuli without a surround (r = -0.10). These results suggest that a neocortical GABA deficit in subjects with schizophrenia leads to impaired cortical inhibition and that GABAergic synaptic transmission in visual cortex plays a critical role in OSSS.

    View details for DOI 10.1523/JNEUROSCI.6158-09.2010

    View details for Web of Science ID 000275400000025

    View details for PubMedID 20220012

  • Perception Measurement in Clinical Trials of Schizophrenia: Promising Paradigms From CNTRICS SCHIZOPHRENIA BULLETIN Green, M. F., Butler, P. D., Chen, Y., Geyer, M. A., Silverstein, S., Wynn, J. K., Yoon, J. H., Zemon, V. 2009; 35 (1): 163-181

    Abstract

    The third meeting of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) focused on selecting promising measures for each of the cognitive constructs selected in the first CNTRICS meeting. In the domain of perception, the 2 constructs of interest were gain control and visual integration. CNTRICS received 5 task nominations for gain control and three task nominations for visual integration. The breakout group for perception evaluated the degree to which each of these tasks met prespecified criteria. For gain control, the breakout group for perception believed that 2 of the tasks (prepulse inhibition of startle and mismatch negativity) were already mature and in the process of being incorporated into multisite clinical trials. However, the breakout group recommended that steady-state visual-evoked potentials be combined with contrast sensitivity to magnocellular vs parvocellular biased stimuli and that this combined task and the contrast-contrast effect task be recommended for translation for use in clinical trial contexts in schizophrenia research. For visual integration, the breakout group recommended the Contour Integration and Coherent Motion tasks for translation for use in clinical trials. This manuscript describes the ways in which each of these tasks met the criteria used by the breakout group to evaluate and recommend tasks for further development.

    View details for DOI 10.1093/schbul/sbn156

    View details for Web of Science ID 000261682700018

    View details for PubMedID 19023123

  • Diminished orientation-specific contextual modulation of visual processing in schizophrenia Schizophrenia Bulletin Yoon, J. H., Rokem, A. S., Silver, M. A., Minzenberg, M. J., Carter, C. J. 2009; 35 (6): 1078-84
  • Association of dorsolateral prefrontal cortex dysfunction with disrupted coordinated brain activity in schizophrenia: Relationship with impaired cognition, behavioral disorganization, and global function AMERICAN JOURNAL OF PSYCHIATRY Yoon, J. H., Minzenberg, M. J., Ursu, S., Walters, R., Wendelken, C., Ragland, J. D., Carter, C. S. 2008; 165 (8): 1006-1014

    Abstract

    Although deficits in cognitive control are thought to contribute to the diverse cognitive and behavioral abnormalities in individuals with schizophrenia, the neural mechanisms underlying these deficits remain unclear. In this event-related functional magnetic resonance imaging (fMRI) study, the authors tested the hypothesis that during cognitive control tasks, impaired activation of the dorsolateral prefrontal cortex in schizophrenia patients is associated with disrupted coordinated activity between this prefrontal region and a distributed brain network that supports cognitive control.Through the use of an event-related design, 25 patients with first-episode schizophrenia and 24 healthy comparison subjects, matched on demographic characteristics, were assessed while performing a version of the AX continuous performance task. Functional neuroimaging data were analyzed using 1) univariate (region-of-interest blood-oxygen-level-dependent [BOLD] time series and whole brain voxel-wise regression) analysis to confirm the presence of dorsolateral prefrontal cortex dysfunction and 2) multivariate analysis to examine dorsolateral prefrontal cortex functional connectivity. In addition, correlations between dorsolateral prefrontal cortex functional connectivity and the following variables were investigated: clinical symptoms, task performance, and coordinated brain activity associated with cognitive control.Schizophrenia patients exhibited a specific deficit in cognitive control, with significantly reduced accuracy in the BX condition relative to any other condition. Univariate fMRI revealed dorsolateral prefrontal cortex dysfunction during the high cognitive control condition. Multivariate analysis revealed significant impairment in functional connectivity between the dorsolateral prefrontal cortex and task-relevant brain regions. Significant correlations were also found between dorsolateral prefrontal cortex functional connectivity and cognitive performance, behavioral disorganization, and global functioning.These findings suggest that there is an association between decreased dorsolateral prefrontal cortex activity and connectivity and a task-related neural network. This deficit in coordinated brain activity may result in the disabling disorganization symptoms related to impaired cognition in individuals with schizophrenia.

    View details for DOI 10.1176/appi.ajp.2008.07060945

    View details for Web of Science ID 000258113700015

    View details for PubMedID 18519527

  • Multivariate Pattern Analysis of fMRI Data Reveals Deficits in Distributed Representations in Schizophrenia Biological Psychiatry Yoon, J. H., Tamir, D., Minzenberg, M. J., Ragland, J., Ursu, S., Carter, C. S. 2008; 64 (12)
  • Modafinil Shifts Human Locus Coeruleus to Low-Tonic, High-Phasic Activity During Functional MRI Science Minzenberg, M. J., Watrous, A. J., Yoon, J. H., Ursu, S., Carter, C. S. 2008; 322 (5908)
  • Segregation of function in the lateral prefrontal cortex during visual object working memory BRAIN RESEARCH Yoon, J. H., Hoffman, J. N., D'Esposito, M. 2007; 1184: 217-225

    Abstract

    Working memory is a set of cognitive operations facilitating higher order cognition and complex behavior. A particularly important aspect of working memory is the linkage of past sensory events to planned actions. While the lateral prefrontal cortex has been proposed to serve this temporal integrative function, the precise mapping of specific components of this process within the lateral prefrontal cortex has yet to be clarified. In this human fMRI experiment, we employed a paradigm that segregates retrospective sensory maintenance from prospective action planning processes. Our results suggest that the ventrolateral PFC supports retrospective sensory representations while the dorsolateral PFC supports prospective action representations.

    View details for DOI 10.1016/j.brainres.2007.09.074

    View details for Web of Science ID 000252096600025

    View details for PubMedID 17980353

  • Neuroimaging of cognitive disability in schizophrenia: Search for a pathophysiological mechanism INTERNATIONAL REVIEW OF PSYCHIATRY Ragland, J. D., Yoon, J., Minzenberg, M. J., Carter, C. S. 2007; 19 (4): 419-429
  • Preserved function of the fusiform face area in schizophrenia as revealed by fMRI PSYCHIATRY RESEARCH-NEUROIMAGING Yoon, J. H., D'Esposito, M., Carter, C. S. 2006; 148 (2-3): 205-216

    Abstract

    Many lines of evidence suggest that individuals with schizophrenia suffer from face processing deficits. However, the specificity of these deficits and the neural dysfunction underlying them remain unclear. To address these questions, we evaluated the functional status of a critical region for face processing, the fusiform face area (FFA), in subjects with schizophrenia. Fourteen schizophrenia patients and 10 healthy control subjects participated in an fMRI experiment to determine the functional status of the FFA by viewing a series of faces and exemplars of other object categories, while completing a low-level task designed to verify their engagement with the stimuli. Behavioral performance and activation of the FFA were equivalent between groups. Thirteen of 14 patients and all control subjects displayed FFA activation. Furthermore, the degree of FFA activation, as measured by FFA volume and magnitude of activity, was similar between groups. The FFA, a critical region in the neural system subserving the perceptual processing of faces, appears to be intact in schizophrenia. These results call into question the presence of a specific face processing deficit in schizophrenia.

    View details for DOI 10.1016/j.pscychresns.2006.06.002

    View details for Web of Science ID 000242885800013

    View details for PubMedID 17095198

  • Differential effects of distraction during working memory on delay-period activity in the prefrontal cortex and the visual association cortex NEUROIMAGE Yoon, J. H., Curtis, C. E., D'Esposito, M. 2006; 29 (4): 1117-1126

    Abstract

    Maintaining relevant information for later use is a critical aspect of working memory (WM). The lateral prefrontal cortex (PFC) and posterior sensory cortical areas appear to be important in supporting maintenance. However, the relative and unique contributions of these areas remain unclear. We have designed a WM paradigm with distraction to probe the contents of maintenance representations in these regions. During delayed recognition trials of faces, selective interference was evident behaviorally with face distraction leading to significantly worse performance than with scene distraction. Event-related fMRI of the human brain showed that maintenance activity in the lateral PFC, but not in visual association cortex (VAC), was selectively disrupted by face distraction. Additionally, the functional connectivity between the lateral PFC and the VAC was perturbed during these trials. We propose a hierarchical and distributed model of active maintenance in which the lateral PFC codes for abstracted mnemonic information, while sensory areas represent specific features of the memoranda. Furthermore, persistent coactivation between the PFC and sensory areas may be a mechanism by which information is actively maintained.

    View details for DOI 10.1016/j.neuroimage.2005.08.024

    View details for Web of Science ID 000235534400009

    View details for PubMedID 16226895

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