Cortical Thinning in Network-Associated Regions in Cognitively Normal and Below-Normal Range Schizophrenia
Identifieur interne : 002253 ( Ncbi/Merge ); précédent : 002252; suivant : 002254Cortical Thinning in Network-Associated Regions in Cognitively Normal and Below-Normal Range Schizophrenia
Auteurs : R. Walter Heinrichs [Canada] ; Farena Pinnock [Canada] ; Melissa Parlar [Canada] ; Colin Hawco [Canada] ; Lindsay Hanford [États-Unis] ; Geoffrey B. Hall [Canada]Source :
- Schizophrenia Research and Treatment [ 2090-2085 ] ; 2017.
Abstract
This study assessed whether cortical thickness across the brain and regionally in terms of the default mode, salience, and central executive networks differentiates schizophrenia patients and healthy controls with normal range or below-normal range cognitive performance. Cognitive normality was defined using the MATRICS Consensus Cognitive Battery (MCCB) composite score (
Url:
DOI: 10.1155/2017/9760905
PubMed: 28348889
PubMed Central: 5350425
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Walter Heinrichs</name><affiliation wicri:level="1"><nlm:aff id="I1">York University, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>York University, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Pinnock, Farena" sort="Pinnock, Farena" uniqKey="Pinnock F" first="Farena" last="Pinnock">Farena Pinnock</name><affiliation wicri:level="1"><nlm:aff id="I1">York University, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>York University, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Parlar, Melissa" sort="Parlar, Melissa" uniqKey="Parlar M" first="Melissa" last="Parlar">Melissa Parlar</name><affiliation wicri:level="1"><nlm:aff id="I1">York University, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>York University, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Hawco, Colin" sort="Hawco, Colin" uniqKey="Hawco C" first="Colin" last="Hawco">Colin Hawco</name><affiliation wicri:level="1"><nlm:aff id="I2">Centre for Addiction and Mental Health, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for Addiction and Mental Health, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Hanford, Lindsay" sort="Hanford, Lindsay" uniqKey="Hanford L" first="Lindsay" last="Hanford">Lindsay Hanford</name><affiliation wicri:level="4"><nlm:aff id="I3">University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Pittsburgh, Pittsburgh, PA</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Hall, Geoffrey B" sort="Hall, Geoffrey B" uniqKey="Hall G" first="Geoffrey B." last="Hall">Geoffrey B. Hall</name><affiliation wicri:level="4"><nlm:aff id="I4">McMaster University, Hamilton, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>McMaster University, Hamilton, ON</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28348889</idno><idno type="pmc">5350425</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350425</idno><idno type="RBID">PMC:5350425</idno><idno type="doi">10.1155/2017/9760905</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000B43</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000B43</idno><idno type="wicri:Area/Pmc/Curation">000B43</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000B43</idno><idno type="wicri:Area/Pmc/Checkpoint">000020</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000020</idno><idno type="wicri:Area/Ncbi/Merge">002253</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cortical Thinning in Network-Associated Regions in Cognitively Normal and Below-Normal Range Schizophrenia</title><author><name sortKey="Heinrichs, R Walter" sort="Heinrichs, R Walter" uniqKey="Heinrichs R" first="R. Walter" last="Heinrichs">R. Walter Heinrichs</name><affiliation wicri:level="1"><nlm:aff id="I1">York University, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>York University, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Pinnock, Farena" sort="Pinnock, Farena" uniqKey="Pinnock F" first="Farena" last="Pinnock">Farena Pinnock</name><affiliation wicri:level="1"><nlm:aff id="I1">York University, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>York University, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Parlar, Melissa" sort="Parlar, Melissa" uniqKey="Parlar M" first="Melissa" last="Parlar">Melissa Parlar</name><affiliation wicri:level="1"><nlm:aff id="I1">York University, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>York University, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Hawco, Colin" sort="Hawco, Colin" uniqKey="Hawco C" first="Colin" last="Hawco">Colin Hawco</name><affiliation wicri:level="1"><nlm:aff id="I2">Centre for Addiction and Mental Health, Toronto, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for Addiction and Mental Health, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Hanford, Lindsay" sort="Hanford, Lindsay" uniqKey="Hanford L" first="Lindsay" last="Hanford">Lindsay Hanford</name><affiliation wicri:level="4"><nlm:aff id="I3">University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Pittsburgh, Pittsburgh, PA</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Hall, Geoffrey B" sort="Hall, Geoffrey B" uniqKey="Hall G" first="Geoffrey B." last="Hall">Geoffrey B. Hall</name><affiliation wicri:level="4"><nlm:aff id="I4">McMaster University, Hamilton, ON, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>McMaster University, Hamilton, ON</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">Schizophrenia Research and Treatment</title><idno type="ISSN">2090-2085</idno><idno type="eISSN">2090-2093</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>This study assessed whether cortical thickness across the brain and regionally in terms of the default mode, salience, and central executive networks differentiates schizophrenia patients and healthy controls with normal range or below-normal range cognitive performance. Cognitive normality was defined using the MATRICS Consensus Cognitive Battery (MCCB) composite score (<italic>T</italic> = 50 ± 10) and structural magnetic resonance imaging was used to generate cortical thickness data. Whole brain analysis revealed that cognitively normal range controls (<italic>n</italic> = 39) had greater cortical thickness than both cognitively normal (<italic>n</italic> = 17) and below-normal range (<italic>n</italic> = 49) patients. Cognitively normal controls also demonstrated greater thickness than patients in regions associated with the default mode and salience, but not central executive networks. No differences on any thickness measure were found between cognitively normal range and below-normal range controls (<italic>n</italic> = 24) or between cognitively normal and below-normal range patients. In addition, structural covariance between network regions was high and similar across subgroups. Positive and negative symptom severity did not correlate with thickness values. Cortical thinning across the brain and regionally in relation to the default and salience networks may index shared aspects of the psychotic psychopathology that defines schizophrenia with no relation to cognitive impairment.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Heinrichs, R W" uniqKey="Heinrichs R">R. W. Heinrichs</name></author><author><name sortKey="Zakzanis, K K" uniqKey="Zakzanis K">K. K. Zakzanis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Weickert, T W" uniqKey="Weickert T">T. W. Weickert</name></author><author><name sortKey="Goldberg, T E" uniqKey="Goldberg T">T. E. Goldberg</name></author><author><name sortKey="Gold, J M" uniqKey="Gold J">J. M. Gold</name></author><author><name sortKey="Bigelow, L B" uniqKey="Bigelow L">L. B. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Schizophr Res Treatment</journal-id><journal-id journal-id-type="iso-abbrev">Schizophr Res Treatment</journal-id><journal-id journal-id-type="publisher-id">SCHIZORT</journal-id><journal-title-group><journal-title>Schizophrenia Research and Treatment</journal-title></journal-title-group><issn pub-type="ppub">2090-2085</issn><issn pub-type="epub">2090-2093</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28348889</article-id><article-id pub-id-type="pmc">5350425</article-id><article-id pub-id-type="doi">10.1155/2017/9760905</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Cortical Thinning in Network-Associated Regions in Cognitively Normal and Below-Normal Range Schizophrenia</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-4884-4854</contrib-id><name><surname>Heinrichs</surname><given-names>R. Walter</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Pinnock</surname><given-names>Farena</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Parlar</surname><given-names>Melissa</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hawco</surname><given-names>Colin</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hanford</surname><given-names>Lindsay</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hall</surname><given-names>Geoffrey B.</given-names></name><xref ref-type="aff" rid="I4"><sup>4</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>York University, Toronto, ON, Canada</aff><aff id="I2"><sup>2</sup>Centre for Addiction and Mental Health, Toronto, ON, Canada</aff><aff id="I3"><sup>3</sup>University of Pittsburgh, Pittsburgh, PA, USA</aff><aff id="I4"><sup>4</sup>McMaster University, Hamilton, ON, Canada</aff><author-notes><corresp id="cor1">*R. Walter Heinrichs: <email>walterh@yorku.ca</email></corresp><fn fn-type="other"><p>Academic Editor: L. Citrome</p></fn></author-notes><pub-date pub-type="ppub"><year>2017</year></pub-date><pub-date pub-type="epub"><day>28</day><month>2</month><year>2017</year></pub-date><volume>2017</volume><elocation-id>9760905</elocation-id><history><date date-type="received"><day>5</day><month>9</month><year>2016</year></date><date date-type="rev-recd"><day>15</day><month>1</month><year>2017</year></date><date date-type="accepted"><day>2</day><month>2</month><year>2017</year></date></history><permissions><copyright-statement>Copyright © 2017 R. Walter Heinrichs et al.</copyright-statement><copyright-year>2017</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>This study assessed whether cortical thickness across the brain and regionally in terms of the default mode, salience, and central executive networks differentiates schizophrenia patients and healthy controls with normal range or below-normal range cognitive performance. Cognitive normality was defined using the MATRICS Consensus Cognitive Battery (MCCB) composite score (<italic>T</italic> = 50 ± 10) and structural magnetic resonance imaging was used to generate cortical thickness data. Whole brain analysis revealed that cognitively normal range controls (<italic>n</italic> = 39) had greater cortical thickness than both cognitively normal (<italic>n</italic> = 17) and below-normal range (<italic>n</italic> = 49) patients. Cognitively normal controls also demonstrated greater thickness than patients in regions associated with the default mode and salience, but not central executive networks. No differences on any thickness measure were found between cognitively normal range and below-normal range controls (<italic>n</italic> = 24) or between cognitively normal and below-normal range patients. In addition, structural covariance between network regions was high and similar across subgroups. Positive and negative symptom severity did not correlate with thickness values. Cortical thinning across the brain and regionally in relation to the default and salience networks may index shared aspects of the psychotic psychopathology that defines schizophrenia with no relation to cognitive impairment.</p></abstract><funding-group><award-group><funding-source xlink:href="http://dx.doi.org/10.13039/501100000024">Canadian Institutes of Health Research</funding-source><award-id>FRN102753</award-id></award-group></funding-group></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Cortical regions [<xref rid="B27" ref-type="bibr">27</xref>] associated with each brain network. Regional overlap between the default mode network (DMN) and salience network (SN) included the left inferior temporal gyrus and middle-anterior cingulate gyrus and sulcus bilaterally. Overlap between the SN network and central executive network (CEN) included the opercular part of the inferior frontal gyrus bilaterally as well as the middle frontal gyrus and left anterior segment of the circular sulcus of the insula. There was no overlap between the DMN and the CEN.</p></caption><graphic xlink:href="SCHIZORT2017-9760905.001"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Descriptive and criterion data for cognitively normal range (CNR) and below-normal range (BNR) patients and controls.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Variable</th><th align="center" rowspan="1" colspan="1">CNR patients (<italic>n</italic> = 17)</th><th align="center" rowspan="1" colspan="1">CNR controls (<italic>n</italic> = 39)</th><th align="center" rowspan="1" colspan="1">BNR patients (<italic>n</italic> = 49)</th><th align="center" rowspan="1" colspan="1">BNR controls (<italic>n</italic> = 24)</th><th align="center" rowspan="1" colspan="1">Statistic</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Age, years (M, SD)</td><td align="center" rowspan="1" colspan="1">34.47 (7.71)</td><td align="center" rowspan="1" colspan="1">37.46 (12.10)</td><td align="center" rowspan="1" colspan="1">43.90 (10.13)</td><td align="center" rowspan="1" colspan="1">41.17 (10.15)</td><td align="center" rowspan="1" colspan="1"><italic>F</italic><sub>3,125</sub> = 4.65<sup><italic>∗∗</italic></sup></td></tr><tr><td align="left" rowspan="1" colspan="1">Education, years (M, SD)</td><td align="center" rowspan="1" colspan="1">14.53 (1.42)</td><td align="center" rowspan="1" colspan="1">13.51 (1.73)</td><td align="center" rowspan="1" colspan="1">12.35 (2.20)</td><td align="center" rowspan="1" colspan="1">10.79 (1.96)</td><td align="center" rowspan="1" colspan="1"><italic>F</italic><sub>3,125</sub> = 15.72<sup><italic>∗∗∗</italic></sup></td></tr><tr><td align="left" rowspan="1" colspan="1">Gender (males %)</td><td align="center" rowspan="1" colspan="1">59</td><td align="center" rowspan="1" colspan="1">62</td><td align="center" rowspan="1" colspan="1">63</td><td align="center" rowspan="1" colspan="1">62</td><td align="center" rowspan="1" colspan="1"><italic>χ</italic><sub>3</sub><sup>2</sup> = 0.11</td></tr><tr><td align="left" rowspan="1" colspan="1">MCCB composite <italic>T</italic> (M, SD)</td><td align="center" rowspan="1" colspan="1">46.94 (5.00)</td><td align="center" rowspan="1" colspan="1">50.51 (6.66)</td><td align="center" rowspan="1" colspan="1">23.31 (9.67)</td><td align="center" rowspan="1" colspan="1">26.54 (10.36)</td><td align="center" rowspan="1" colspan="1"><italic>F</italic><sub>3,125</sub> = 93.18<sup><italic>∗∗∗</italic></sup></td></tr><tr><td align="left" rowspan="1" colspan="1">WRAT-4 Reading <italic>SS</italic> (M, SD)</td><td align="center" rowspan="1" colspan="1">100.53 (7.32)</td><td align="center" rowspan="1" colspan="1">101.18 (8.53)</td><td align="center" rowspan="1" colspan="1">87.87 (11.45)</td><td align="center" rowspan="1" colspan="1">84.83 (10.28)</td><td align="center" rowspan="1" colspan="1"><italic>F</italic><sub>3,123</sub> = 21.73<sup><italic>∗∗∗</italic></sup></td></tr><tr><td align="left" rowspan="1" colspan="1">PANSS positive <italic>T</italic> (M, SD)</td><td align="center" rowspan="1" colspan="1">38.82 (6.19)</td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1">42.43 (7.90)</td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1"><italic>t</italic><sub>64</sub> = 1.70</td></tr><tr><td align="left" rowspan="1" colspan="1">PANSS negative <italic>T</italic> (M, SD)</td><td align="center" rowspan="1" colspan="1">37.29 (7.73)</td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1">39.24 (6.54)</td><td align="center" rowspan="1" colspan="1">—</td><td align="center" rowspan="1" colspan="1"><italic>t</italic><sub>64</sub> = 1.01</td></tr><tr><td align="left" rowspan="1" colspan="1">Medication (2nd generation)</td><td align="center" rowspan="1" colspan="1">76%</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1">65%</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"><italic>χ</italic><sub>1</sub><sup>2</sup> = 3.43</td></tr></tbody></table><table-wrap-foot><fn><p><italic>Note</italic>. MCCB: MATRICS Consensus Cognitive Battery; PANSS: Positive and Negative Syndrome Scale; WRAT-4: Wide Range Achievement Test.</p></fn><fn><p><sup><italic>∗∗</italic></sup><italic>p</italic> < 0.01.</p></fn><fn><p><sup><italic>∗∗∗</italic></sup><italic>p</italic> < 0.001.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Cortical thickness (mm) in cognitively normal range (CNR) and below-normal range (BNR) patients and controls adjusted for age.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Region/network</th><th align="center" rowspan="1" colspan="1">(1) CNR<break></break>patients<break></break> (<italic>n</italic> = 17) <break></break>M, SD</th><th align="center" rowspan="1" colspan="1">(2) CNR<break></break>controls<break></break> (<italic>n</italic> = 39) <break></break>M, SD</th><th align="center" rowspan="1" colspan="1">(3) BNR<break></break>patients<break></break> (<italic>n</italic> = 49) <break></break>M, SD</th><th align="center" rowspan="1" colspan="1">(4) BNR<break></break>controls<break></break> (<italic>n</italic> = 24) <break></break>M, SD</th><th align="left" rowspan="1" colspan="1"><italic>F</italic>(3,123)</th><th align="center" rowspan="1" colspan="1">Bonferroni adjusted comparisons</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Whole brain</td><td align="center" rowspan="1" colspan="1">2.46 (.10)</td><td align="center" rowspan="1" colspan="1">2.54 (.10)</td><td align="center" rowspan="1" colspan="1">2.46 (.10)</td><td align="center" rowspan="1" colspan="1">2.51 (.10)</td><td align="left" rowspan="1" colspan="1">5.56<sup><italic>∗∗</italic></sup></td><td align="center" rowspan="1" colspan="1">2 > 1,3</td></tr><tr><td align="left" rowspan="1" colspan="1">Default mode</td><td align="center" rowspan="1" colspan="1">2.55 (.11)</td><td align="center" rowspan="1" colspan="1">2.68 (.11)</td><td align="center" rowspan="1" colspan="1">2.56 (.11)</td><td align="center" rowspan="1" colspan="1">2.62 (.11)</td><td align="left" rowspan="1" colspan="1">8.93<sup><italic>∗∗∗</italic></sup></td><td align="center" rowspan="1" colspan="1">2 > 1,3</td></tr><tr><td align="left" rowspan="1" colspan="1">Salience</td><td align="center" rowspan="1" colspan="1">2.70 (.12)</td><td align="center" rowspan="1" colspan="1">2.81 (.12)</td><td align="center" rowspan="1" colspan="1">2.72 (.12)</td><td align="center" rowspan="1" colspan="1">2.77 (.12)</td><td align="left" rowspan="1" colspan="1">6.25<sup><italic>∗∗</italic></sup></td><td align="center" rowspan="1" colspan="1">2 > 1,3</td></tr><tr><td align="left" rowspan="1" colspan="1">Central executive</td><td align="center" rowspan="1" colspan="1">2.55 (.13)</td><td align="center" rowspan="1" colspan="1">2.61 (.12)</td><td align="center" rowspan="1" colspan="1">2.57 (.13)</td><td align="center" rowspan="1" colspan="1">2.61 (.12)</td><td align="left" rowspan="1" colspan="1">1.65</td><td align="center" rowspan="1" colspan="1"> </td></tr></tbody></table><table-wrap-foot><fn><p><sup><italic>∗∗</italic></sup><italic>p</italic> < 0.01.</p></fn><fn><p><sup><italic>∗∗∗</italic></sup><italic>p</italic> < 0.001.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Ontario</li><li>Pennsylvanie</li></region><settlement><li>Hamilton (Ontario)</li><li>Pittsburgh</li></settlement><orgName><li>Université McMaster</li><li>Université de Pittsburgh</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Heinrichs, R Walter" sort="Heinrichs, R Walter" uniqKey="Heinrichs R" first="R. Walter" last="Heinrichs">R. Walter Heinrichs</name></noRegion><name sortKey="Hall, Geoffrey B" sort="Hall, Geoffrey B" uniqKey="Hall G" first="Geoffrey B." last="Hall">Geoffrey B. Hall</name><name sortKey="Hawco, Colin" sort="Hawco, Colin" uniqKey="Hawco C" first="Colin" last="Hawco">Colin Hawco</name><name sortKey="Parlar, Melissa" sort="Parlar, Melissa" uniqKey="Parlar M" first="Melissa" last="Parlar">Melissa Parlar</name><name sortKey="Pinnock, Farena" sort="Pinnock, Farena" uniqKey="Pinnock F" first="Farena" last="Pinnock">Farena Pinnock</name></country><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Hanford, Lindsay" sort="Hanford, Lindsay" uniqKey="Hanford L" first="Lindsay" last="Hanford">Lindsay Hanford</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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