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Kuo SS, Pogue-Geile MF. Variation in fourteen brain structure volumes in schizophrenia: A comprehensive meta-analysis of 246 studies. Neurosci Biobehav Rev 2019; 98:85-94. [PMID: 30615934 PMCID: PMC6401304 DOI: 10.1016/j.neubiorev.2018.12.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 11/21/2018] [Accepted: 12/31/2018] [Indexed: 12/24/2022]
Abstract
Despite hundreds of structural MRI studies documenting smaller brain volumes on average in schizophrenia compared to controls, little attention has been paid to group differences in the variability of brain volumes. Examination of variability may help interpret mean group differences in brain volumes and aid in better understanding the heterogeneity of schizophrenia. Variability in 246 MRI studies was meta-analyzed for 13 structures that have shown medium to large mean effect sizes (Cohen's d≥0.4): intracranial volume, total brain volume, lateral ventricles, third ventricle, total gray matter, frontal gray matter, prefrontal gray matter, temporal gray matter, superior temporal gyrus gray matter, planum temporale, hippocampus, fusiform gyrus, insula; and a control structure, caudate nucleus. No significant differences in variability in cortical/subcortical volumes were detected in schizophrenia relative to controls. In contrast, increased variability was found in schizophrenia compared to controls for intracranial and especially lateral and third ventricle volumes. These findings highlight the need for more attention to ventricles and detailed analyses of brain volume distributions to better elucidate the pathophysiology of schizophrenia.
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Affiliation(s)
- Susan S Kuo
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
| | - Michael F Pogue-Geile
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA; Department of Psychology and Department of Psychiatry, University of Pittsburgh, 4207 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
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Mendrek A, Mancini-Marïe A. Sex/gender differences in the brain and cognition in schizophrenia. Neurosci Biobehav Rev 2015; 67:57-78. [PMID: 26743859 DOI: 10.1016/j.neubiorev.2015.10.013] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/17/2015] [Accepted: 10/26/2015] [Indexed: 01/03/2023]
Abstract
The early conceptualizations of schizophrenia have noted some sex/gender differences in epidemiology and clinical expression of the disorder. Over the past few decades, the interest in differences between male and female patients has expanded to encompass brain morphology and neurocognitive function. Despite some variability and methodological shortcomings, a few patterns emerge from the available literature. Most studies of gross neuroanatomy show more enlarged ventricles and smaller frontal lobes in men than in women with schizophrenia; finding reflecting normal sexual dimorphism. In comparison, studies of brain asymmetry and specific corticolimbic structures, suggest a disturbance in normal sexual dimorphism. The neurocognitive findings are somewhat consistent with this picture. Studies of cognitive functions mediated by the lateral frontal network tend to show sex differences in patients which are in the same direction as those observed in the general population, whereas studies of processes mediated by the corticolimbic system more frequently reveal reversal of normal sexual dimorphisms. These trends are faint and future research would need to delineate neurocognitive differences between men and women with various subtypes of schizophrenia (e.g., early versus late onset), while taking into consideration hormonal status and gender of tested participants.
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Affiliation(s)
- Adrianna Mendrek
- Department of Psychology, Bishop's University, Sherbrooke, QC, Canada; Department of Psychiatry, Université de Montréal, Montreal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Adham Mancini-Marïe
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada; Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada; Department of Psychiatry, Centre neuchâtelois de psychiatrie, Neuchâtel, Suisse
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3
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Rapado-Castro M, Bartholomeusz CF, Castro-Fornieles J, González-Pinto A, Otero S, Baeza I, Moreno C, Graell M, Janssen J, Bargalló N, Pantelis C, Desco M, Arango C. Gender effects on brain changes in early-onset psychosis. Eur Child Adolesc Psychiatry 2015; 24:1193-205. [PMID: 25589436 DOI: 10.1007/s00787-014-0669-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/18/2014] [Indexed: 11/24/2022]
Abstract
Progressive loss of cortical gray matter (GM) and increase of cerebrospinal fluid (CSF) have been reported in early-onset psychosis (EOP). EOP typically begins during adolescence, a time when developmental brain trajectories differ by gender. This study aimed to determine gender differences in progression of brain changes in this population. A sample of 61 (21 females) adolescents with a first psychotic episode and a matched sample of 70 (23 females) controls underwent both baseline and 2-year follow-up anatomical brain imaging assessments. Regional GM and CSF volumes were obtained using automated methods based on the Talairach's proportional grid system. At baseline, only male patients showed a clear pattern of alterations in the frontal lobe relative to controls (smaller GM and larger CSF volumes). However, parallel longitudinal changes for male and female patients relative to controls were observed, resulting in a common pattern of brain changes across both genders: rate of left frontal lobe GM volume loss was larger in male (-3.8%) and female patients (-4.2%) than in controls (-0.7% males; -0.4% females). The reverse was found for the CSF volume in the left frontal lobe. While the GM and CSF volumes of females with EOP appear to be within the normal range at initial illness onset, our results point to a similar trajectory of increased/accelerated brain changes in both male and female patients with EOP. The pattern of progression of brain changes in psychosis appears to be independent of gender or structural alterations on appearance of psychotic symptoms.
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Affiliation(s)
- Marta Rapado-Castro
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain.
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia.
| | - Cali F Bartholomeusz
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia
| | - Josefina Castro-Fornieles
- Child Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic de Barcelona, IDIBAPS, SGR-1119, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Ana González-Pinto
- Hospital Santiago Apóstol de Vitoria, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Kronikgune, EHU-UPV, Vitoria, Spain
| | - Soraya Otero
- Child Psychiatry Unit, Hospital Universitario Marqués de Valdecilla, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santander, Spain
| | - Inmaculada Baeza
- Child Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic de Barcelona, IDIBAPS, SGR-1119, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Carmen Moreno
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Montserrat Graell
- Psychiatry and Psychology Department, Hospital Infantil Universitario Niño Jesús, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Joost Janssen
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
- Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Nuria Bargalló
- Image Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia
| | - Manuel Desco
- Department of Bioengineering and Aerospatial Engineering, University Carlos III de Madrid, Madrid, Spain
- Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
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Molina V, Papiol S, Sanz J, Rosa A, Arias B, Fatjó-Vilas M, Calama J, Hernández AI, Bécker J, Fañanás L. Convergent evidence of the contribution of TP53 genetic variation (Pro72Arg) to metabolic activity and white matter volume in the frontal lobe in schizophrenia patients. Neuroimage 2011; 56:45-51. [PMID: 21296169 DOI: 10.1016/j.neuroimage.2011.01.076] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 01/13/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022] Open
Abstract
Abnormalities in white matter (WM) volumes and integrity in schizophrenia, together with post-mortem studies showing reduced expression of oligodendrocyte/myelination genes and apoptotic processes taking place in oligodendrocytes, suggest the interest of major regulators of apoptosis as candidate genes for some features related to myelin integrity in schizophrenia. Protein p53, encoded by TP53 gene, has a central role in the control of apoptosis and is involved in oligodendrocyte development. TP53 gene polymorphisms may account for variability in WM features, metabolic activity and biochemical markers of neuronal integrity and membrane turnover. Pro72Arg and Ins16bp polymorphisms at TP53 gene were analyzed in 20 DSM-IV schizophrenia patients. T1/T2-weighted sequences of these patients were acquired using a 1.5T Philips Gyroscan system. Scans were transformed into Talairach space and segmented into gray matter (GM), WM and cerebrospinal fluid (CSF) using Statistical Parametric Mapping under a ROI approach. Likewise dorsolateral prefrontal cortex (DLPFC) metabolic activity was measured using a procedure based on MRI/PET image fusion. In 13 of these patients proton magnetic resonance spectroscopy was used to examine N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) levels in dorsolateral-medial prefrontal cortex (DLMPFC). MRI data were adjusted for age and brain volume using regression parameters from a healthy control group (n=45). Patients Pro/Arg heterozygous (Pro72Arg polymorphism) showed a generalized deficit in whole-brain WM that was especially prominent in frontal lobe and a lower metabolic activity in the DLPFC as compared to Pro/Pro homozygous. Pro/Arg subjects also showed decreased NAA/Cho and increased Cho/Cr ratios in right DLMPFC. TP53 genetic variability influences WM volumes in frontal lobes and it seems to modulate the metabolic activity in this region. Our results suggest that TP53 might influence aspects of myelin and white matter integrity which may account for some of the frontal dysfunction features commonly described in these patients.
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Affiliation(s)
- Vicente Molina
- Department of Psychiatry, Hospital Clínico de Salamanca, Salamanca, Spain.
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Reig S, Moreno C, Moreno D, Burdalo M, Janssen J, Parellada M, Zabala A, Desco M, Arango C. Progression of brain volume changes in adolescent-onset psychosis. Schizophr Bull 2009; 35:233-43. [PMID: 18222929 PMCID: PMC2643965 DOI: 10.1093/schbul/sbm160] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Little is known about the changes that take place in the adolescent brain over the first few years following the onset of psychosis. The present longitudinal study builds on an earlier cross-sectional report demonstrating brain abnormalities in adolescent-onset psychosis patients with a recent-onset first episode of psychosis. Magnetic resonance imaging studies were obtained at baseline and 2 years later from 21 adolescents with psychosis and 34 healthy controls matched for age, gender, and years of education. Whole-brain volumes and gray matter (GM) and cerebrospinal fluid (CSF) volumes of the frontal, parietal, temporal, and occipital lobes were measured at baseline and at 2-year follow-up. In the frontal lobe, the rate of GM volume loss was significantly higher in male patients (2.9% and 2.0%, respectively, for left and right) than in controls (1.2% and 0.7%, respectively, for left and right). In the left frontal lobe, male patients showed a significantly higher rate of CSF volume increase than controls (8.6% vs 6.4%). These differences in rates of volume change were observed in male and female patients, although only males showed significant time x diagnosis interactions. This negative finding in females should be interpreted with caution as the study was underpowered to detect change in women due to limited sample size. An exploratory analysis revealed that schizophrenia and nonschizophrenia psychotic disorders showed similar volume change patterns relative to controls. Change in clinical status was not correlated with longitudinal brain changes. Our results support progression of frontal lobe changes in males with adolescent-onset psychosis.
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Affiliation(s)
| | - Carmen Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dolores Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Maite Burdalo
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Joost Janssen
- Department of Experimental Medicine,Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Mara Parellada
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Arantzazu Zabala
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Celso Arango
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain,To whom correspondence should be addressed; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Dr Esquerdo 46, Madrid 28007, Spain; tel: 34-914265057, fax: 34-914265108, e-mail:
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Premkumar P, Fannon D, Kuipers E, Cooke MA, Simmons A, Kumari V. Association between a longer duration of illness, age and lower frontal lobe grey matter volume in schizophrenia. Behav Brain Res 2008; 193:132-9. [PMID: 18586335 DOI: 10.1016/j.bbr.2008.05.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 05/07/2008] [Accepted: 05/10/2008] [Indexed: 11/19/2022]
Abstract
The frontal lobe has an extended maturation period and may be vulnerable to the long-term effects of schizophrenia. We tested this hypothesis by studying the relationship between duration of illness (DoI), grey matter (GM) and cerebro-spinal fluid (CSF) volume across the whole brain. Sixty-four patients with schizophrenia and 25 healthy controls underwent structural MRI scanning and neuropsychological assessment. We performed regression analyses in patients to examine the relationship between DoI and GM and CSF volumes across the whole brain, and correlations in controls between age and GM or CSF volume of the regions where GM or CSF volumes were associated with DoI in patients. Correlations were also performed between GM volume in the regions associated with DoI and neuropsychological performance. A longer DoI was associated with lower GM volume in the left dorsomedial prefrontal cortex (PFC), right middle frontal cortex, left fusiform gyrus (FG) and left cerebellum (lobule III). Additionally, age was inversely associated with GM volume in the left dorsomedial PFC in patients, and in the left FG and CSF excess near the left cerebellum in healthy controls. Greater GM volume in the left dorsomedial PFC was associated with better working memory, attention and psychomotor speed in patients. Our findings suggest that the right middle frontal cortex is particularly vulnerable to the long-term effect of schizophrenia illness whereas the dorsomedial PFC, FG and cerebellum are affected by both a long DoI and aging. The effect of illness chronicity on GM volume in the left dorsomedial PFC may be extended to brain structure-neuropsychological function relationships.
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Affiliation(s)
- Preethi Premkumar
- Department of Psychology, Institute of Psychiatry, De Crespigny Park, King's College London, London SE5 8AF, United Kingdom.
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