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Li X, Lin Z, Liu C, Bai R, Wu D, Yang J. Glymphatic Imaging in Pediatrics. J Magn Reson Imaging 2024; 59:1523-1541. [PMID: 37819198 DOI: 10.1002/jmri.29040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
The glymphatic system, which facilitates cerebrospinal fluid (CSF) flow through the brain parenchyma, is important for brain development and waste clearance. Advances in imaging techniques, particularly magnetic resonance imaging, have make it possible to evaluate glymphatic structures and functions in vivo. Recently, several studies have focused on the development and alterations of the glymphatic system in pediatric disorders. This review discusses the development of the glymphatic system, advances of imaging techniques and their applications in pediatric disorders. First, the results of the reviewed studies indicate that the development of the glymphatic system is a long-lasting process that continues into adulthood. Second, there is a need for improved glymphatic imaging techniques that are non-invasive and fast to improve suitability for pediatric applications, as some of existing methods use contrast injection and are susceptible to motion artifacts from long scanning times. Several novel techniques are potentially feasible for pediatric patients and may be used in the future. Third, the glymphatic dysfunction is associated with a large number of pediatric disorders, although only a few have recently been investigated. In conclusion, research on the pediatric glymphatic system remains an emerging field. The preliminary applications of glymphatic imaging techniques have provided unique insight into the pathological mechanism of pediatric diseases, but mainly limited in visualization of enlarged perivascular spaces and morphological measurements on CSF volumes. More in-depth studies on glymphatic functions are required to improve our understanding of the mechanisms underlying brain development and pediatric diseases. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xianjun Li
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zixuan Lin
- Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Congcong Liu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ruiliang Bai
- Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dan Wu
- Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shaanxi Engineering Research Center of Computational Imaging and Medical Intelligence, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Cui Y, Li C, Liu B, Sui J, Song M, Chen J, Chen Y, Guo H, Li P, Lu L, Lv L, Ning Y, Wan P, Wang H, Wang H, Wu H, Yan H, Yan J, Yang Y, Zhang H, Zhang D, Jiang T. Consistent brain structural abnormalities and multisite individualised classification of schizophrenia using deep neural networks. Br J Psychiatry 2022; 221:732-739. [PMID: 35144702 DOI: 10.1192/bjp.2022.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Previous analyses of grey and white matter volumes have reported that schizophrenia is associated with structural changes. Deep learning is a data-driven approach that can capture highly compact hierarchical non-linear relationships among high-dimensional features, and therefore can facilitate the development of clinical tools for making a more accurate and earlier diagnosis of schizophrenia. AIMS To identify consistent grey matter abnormalities in patients with schizophrenia, 662 people with schizophrenia and 613 healthy controls were recruited from eight centres across China, and the data from these independent sites were used to validate deep-learning classifiers. METHOD We used a prospective image-based meta-analysis of whole-brain voxel-based morphometry. We also automatically differentiated patients with schizophrenia from healthy controls using combined grey matter, white matter and cerebrospinal fluid volumetric features, incorporated a deep neural network approach on an individual basis, and tested the generalisability of the classification models using independent validation sites. RESULTS We found that statistically reliable schizophrenia-related grey matter abnormalities primarily occurred in regions that included the superior temporal gyrus extending to the temporal pole, insular cortex, orbital and middle frontal cortices, middle cingulum and thalamus. Evaluated using leave-one-site-out cross-validation, the performance of the classification of schizophrenia achieved by our findings from eight independent research sites were: accuracy, 77.19-85.74%; sensitivity, 75.31-89.29% and area under the receiver operating characteristic curve, 0.797-0.909. CONCLUSIONS These results suggest that, by using deep-learning techniques, multidimensional neuroanatomical changes in schizophrenia are capable of robustly discriminating patients with schizophrenia from healthy controls, findings which could facilitate clinical diagnosis and treatment in schizophrenia.
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Affiliation(s)
- Yue Cui
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China
| | - Chao Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China
| | - Bing Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, China and Chinese Institute for Brain Research, China
| | - Jing Sui
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, China
| | - Ming Song
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, China
| | - Yunchun Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, China
| | - Peng Li
- Peking University Sixth Hospital/Institute of Mental Health, China and Key Laboratory of Mental Health, Ministry of Health (Peking University), China
| | - Lin Lu
- Peking University Sixth Hospital/Institute of Mental Health, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), China and Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China and Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, China
| | - Yuping Ning
- Guangzhou Brain Hospital, Guangzhou Hui-Ai Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, China
| | - Ping Wan
- Zhumadian Psychiatric Hospital, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, China
| | - Huawang Wu
- Guangzhou Brain Hospital, Guangzhou Hui-Ai Hospital, The Affiliated Brain Hospital of Guangzhou Medical University, China
| | - Hao Yan
- Peking University Sixth Hospital/Institute of Mental Health, China and Key Laboratory of Mental Health, Ministry of Health (Peking University), China
| | - Jun Yan
- Peking University Sixth Hospital/Institute of Mental Health, China and Key Laboratory of Mental Health, Ministry of Health (Peking University), China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China, Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, China and CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, China, Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, China and Department of Psychology, Xinxiang Medical University, China
| | - Dai Zhang
- Peking University Sixth Hospital/Institute of Mental Health, China, Key Laboratory of Mental Health, Ministry of Health (Peking University), China and Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, China
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, China, National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, China and University of Chinese Academy of Sciences, China, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, China; Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, China and Queensland Brain Institute, University of Queensland, Australia
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3
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Structural and Functional Deviations of the Hippocampus in Schizophrenia and Schizophrenia Animal Models. Int J Mol Sci 2022; 23:ijms23105482. [PMID: 35628292 PMCID: PMC9143100 DOI: 10.3390/ijms23105482] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 01/04/2023] Open
Abstract
Schizophrenia is a grave neuropsychiatric disease which frequently onsets between the end of adolescence and the beginning of adulthood. It is characterized by a variety of neuropsychiatric abnormalities which are categorized into positive, negative and cognitive symptoms. Most therapeutical strategies address the positive symptoms by antagonizing D2-dopamine-receptors (DR). However, negative and cognitive symptoms persist and highly impair the life quality of patients due to their disabling effects. Interestingly, hippocampal deviations are a hallmark of schizophrenia and can be observed in early as well as advanced phases of the disease progression. These alterations are commonly accompanied by a rise in neuronal activity. Therefore, hippocampal formation plays an important role in the manifestation of schizophrenia. Furthermore, studies with animal models revealed a link between environmental risk factors and morphological as well as electrophysiological abnormalities in the hippocampus. Here, we review recent findings on structural and functional hippocampal abnormalities in schizophrenic patients and in schizophrenia animal models, and we give an overview on current experimental approaches that especially target the hippocampus. A better understanding of hippocampal aberrations in schizophrenia might clarify their impact on the manifestation and on the outcome of this severe disease.
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Avram M, Grothe MJ, Meinhold L, Leucht C, Leucht S, Borgwardt S, Brandl F, Sorg C. Lower cholinergic basal forebrain volumes link with cognitive difficulties in schizophrenia. Neuropsychopharmacology 2021; 46:2320-2329. [PMID: 34188186 PMCID: PMC8580980 DOI: 10.1038/s41386-021-01070-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/01/2021] [Accepted: 06/12/2021] [Indexed: 02/06/2023]
Abstract
A potential pathophysiological mechanism of cognitive difficulties in schizophrenia is a dysregulated cholinergic system. Particularly, the cholinergic basal forebrain nuclei (BFCN), the source of cortical cholinergic innervation, support multiple cognitive functions, ranging from attention to decision-making. We hypothesized that BFCN structural integrity is altered in schizophrenia and associated with patients' attentional deficits. We assessed gray matter (GM) integrity of cytoarchitectonically defined BFCN region-of-interest in 72 patients with schizophrenia and 73 healthy controls, matched for age and gender, from the COBRE open-source database, via structural magnetic resonance imaging (MRI)-based volumetry. MRI-derived measures of GM integrity (i.e., volumes) were linked with performance on a symbol coding task (SCT), a paper-pencil-based metric that assesses attention, by correlation and mediation analysis. To assess the replicability of findings, we repeated the analyses in an independent dataset comprising 26 patients with schizophrenia and 24 matched healthy controls. BFCN volumes were lower in patients (t(139)=2.51, p = 0.01) and significantly associated with impaired SCT performance (r = 0.31, p = 0.01). Furthermore, lower BFCN volumes mediated the group difference in SCT performance. When including global GM volumes, which were lower in patients, as covariates-of-no-interest, these findings disappeared, indicating that schizophrenia did not have a specific effect on BFCN relative to other regional volume changes. We replicated these findings in the independent cohort, e.g., BFCN volumes were lower in patients and mediated patients' impaired SCT performance. Results demonstrate lower BFCN volumes in schizophrenia, which link with patients' attentional deficits. Data suggest that a dysregulated cholinergic system might contribute to cognitive difficulties in schizophrenia via impaired BFCN.
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Affiliation(s)
- Mihai Avram
- Department of Psychiatry and Psychotherapy, Schleswig Holstein University Hospital, University of Lübeck, Lübeck, 23538, Germany.
| | - Michel J. Grothe
- grid.414816.e0000 0004 1773 7922Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Lena Meinhold
- grid.6936.a0000000123222966TUM-NIC Neuroimaging Center, Technical University of Munich, School of Medicine, Munich, 81675 Germany
| | - Claudia Leucht
- grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, 81675 Germany
| | - Stefan Leucht
- grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, 81675 Germany
| | - Stefan Borgwardt
- grid.4562.50000 0001 0057 2672Department of Psychiatry and Psychotherapy, Schleswig Holstein University Hospital, University of Lübeck, Lübeck, 23538 Germany
| | - Felix Brandl
- grid.6936.a0000000123222966TUM-NIC Neuroimaging Center, Technical University of Munich, School of Medicine, Munich, 81675 Germany ,grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, 81675 Germany ,grid.6936.a0000000123222966Department of Neuroradiology, Technical University of Munich, School of Medicine, Munich, 81675 Germany
| | - Christian Sorg
- grid.6936.a0000000123222966TUM-NIC Neuroimaging Center, Technical University of Munich, School of Medicine, Munich, 81675 Germany ,grid.6936.a0000000123222966Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, 81675 Germany ,grid.6936.a0000000123222966Department of Neuroradiology, Technical University of Munich, School of Medicine, Munich, 81675 Germany
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5
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Cerebrospinal Fluid Magnetic Resonance Imaging: Improving Early Diagnosis of Autism and Other Neurodevelopmental Conditions. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:635-637. [PMID: 32646616 DOI: 10.1016/j.bpsc.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/17/2020] [Indexed: 11/21/2022]
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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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7
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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: 175] [Impact Index Per Article: 19.4] [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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8
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Yang Y, Nuechterlein KH, Phillips OR, Gutman B, Kurth F, Dinov I, Thompson PM, Asarnow RF, Toga AW, Narr KL. Disease and genetic contributions toward local tissue volume disturbances in schizophrenia: a tensor-based morphometry study. Hum Brain Mapp 2012; 33:2081-91. [PMID: 22241649 DOI: 10.1002/hbm.21349] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Structural brain deficits, especially frontotemporal volume reduction and ventricular enlargement, have been repeatedly reported in patients with schizophrenia. However, it remains unclear whether brain structural deformations may be attributable to disease-related or genetic factors. In this study, the structural magnetic resonance imaging data of 48 adult-onset schizophrenia patients, 65 first-degree nonpsychotic relatives of schizophrenia patients, 27 community comparison (CC) probands, and 73 CC relatives were examined using tensor-based morphometry (TBM) to isolate global and localized differences in tissue volume across the entire brain between groups. We found brain tissue contractions most prominently in frontal and temporal regions and expansions in the putamen/pallidum, and lateral and third ventricles in schizophrenia patients when compared with unrelated CC probands. Results were similar, though less prominent when patients were compared with their nonpsychotic relatives. Structural deformations observed in unaffected patient relatives compared to age-similar CC relatives were suggestive of schizophrenia-related genetic liability and were pronounced in the putamen/pallidum and medial temporal regions. Schizophrenia and genetic liability effects for the putamen/pallidum were confirmed by regions-of-interest analysis. In conclusion, TBM findings complement reports of frontal, temporal, and ventricular dysmorphology in schizophrenia and further indicate that putamen/pallidum enlargements, originally linked mainly with medication exposure in early studies, also reflect a genetic predisposition for schizophrenia. Thus, brain deformation profiles revealed in this study may help to clarify the role of specific genetic or environmental risk factors toward altered brain morphology in schizophrenia.
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Affiliation(s)
- Yaling Yang
- Laboratory of Neuro Imaging, Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
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Via E, Cardoner N, Pujol J, Martínez-Zalacaín I, Hernández-Ribas R, Urretavizacaya M, López-Solà M, Deus J, Menchón JM, Soriano-Mas C. Cerebrospinal fluid space alterations in melancholic depression. PLoS One 2012; 7:e38299. [PMID: 22761673 PMCID: PMC3386250 DOI: 10.1371/journal.pone.0038299] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 05/03/2012] [Indexed: 01/29/2023] Open
Abstract
Melancholic depression is a biologically homogeneous clinical entity in which structural brain alterations have been described. Interestingly, reports of structural alterations in melancholia include volume increases in Cerebro-Spinal Fluid (CSF) spaces. However, there are no previous reports of CSF volume alterations using automated whole-brain voxel-wise approaches, as tissue classification algorithms have been traditionally regarded as less reliable for CSF segmentation. Here we aimed to assess CSF volumetric alterations in melancholic depression and their clinical correlates by means of a novel segmentation algorithm (‘new segment’, as implemented in the software Statistical Parametric Mapping-SPM8), incorporating specific features that may improve CSF segmentation. A three-dimensional Magnetic Resonance Image (MRI) was obtained from seventy patients with melancholic depression and forty healthy control subjects. Although imaging data were pre-processed with the ‘new segment’ algorithm, in order to obtain a comparison with previous segmentation approaches, tissue segmentation was also performed with the ‘unified segmentation’ approach. Melancholic patients showed a CSF volume increase in the region of the left Sylvian fissure, and a CSF volume decrease in the subarachnoid spaces surrounding medial and lateral parietal cortices. Furthermore, CSF increases in the left Sylvian fissure were negatively correlated with the reduction percentage of depressive symptoms at discharge. None of these results were replicated with the ‘unified segmentation’ approach. By contrast, between-group differences in the left Sylvian fissure were replicated with a non-automated quantification of the CSF content of this region. Left Sylvian fissure alterations reported here are in agreement with previous findings from non-automated CSF assessments, and also with other reports of gray and white matter insular alterations in depressive samples using automated approaches. The reliable characterization of CSF alterations may help in the comprehensive characterization of brain structural abnormalities in psychiatric samples and in the development of etiopathogenic hypotheses relating to the disorders.
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Affiliation(s)
- Esther Via
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | | | | | - Rosa Hernández-Ribas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Mikel Urretavizacaya
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Joan Deus
- CRC Hospital del Mar, Barcelona, Spain
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - José Manuel Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
- * E-mail:
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Sayo A, Jennings RG, Van Horn JD. Study factors influencing ventricular enlargement in schizophrenia: a 20 year follow-up meta-analysis. Neuroimage 2011; 59:154-67. [PMID: 21787868 DOI: 10.1016/j.neuroimage.2011.07.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 06/23/2011] [Accepted: 07/04/2011] [Indexed: 12/13/2022] Open
Abstract
A meta-analysis was performed on studies employing the ventricular-brain ratio to compare schizophrenic subjects to that of normal controls. This was a follow-up to a similar meta-analysis published in 1992 in which study-, in addition to clinical-, factors were found to contribute significantly to the reported difference between patients with schizophrenia and controls. Seventy-two (N=72) total studies were identified from the peer reviewed literature, 39 from the original meta-analysis, and 33 additional studies published since which met strict criteria for inclusion and analysis - thus representing ~30 years of schizophrenia ventricular enlargement research. Sample characteristics from schizophrenics and controls were coded for use as predictor variables against within sample VBR values as well as for between sample VBR differences. Additionally, a number of factors concerning how the studies were conducted and reported were also coded. Obtained data was subjected to unweighted univariate as well as multiple regression analyses. In particular, results indicated significant differences between schizophrenics and controls in ventricular size but also the influence of the diagnostic criteria used to define schizophrenia on the magnitude of the reported VBR. This suggests that differing factors of the diagnostic criteria may be sensitive to ventricular enlargement and might be worthy of further examination. Interestingly, we observed an inverse relationship between VBR difference and the number of co-authors on the study. This latter finding suggests that larger research groups report smaller VBR differences and may be more conservative or exacting in their research methodology. Analyses weighted by sample size provided identical conclusions. The effects of study factors such as these are helpful for understanding the variation in the size of the reported differences in VBR between patients and controls as well as for understanding the evolution of research on complex clinical syndromes employing neuroimaging morphometrics.
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Affiliation(s)
- Angelo Sayo
- Laboratory of Neuro Imaging (LONI), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 635 Charles E. Young Drive SW, Suite 225, Los Angeles, CA 90095-7334, USA
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Horga G, Bernacer J, Dusi N, Entis J, Chu K, Hazlett EA, Mehmet Haznedar M, Kemether E, Byne W, Buchsbaum MS. Correlations between ventricular enlargement and gray and white matter volumes of cortex, thalamus, striatum, and internal capsule in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2011; 261:467-76. [PMID: 21431919 PMCID: PMC3182327 DOI: 10.1007/s00406-011-0202-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 02/15/2011] [Indexed: 11/25/2022]
Abstract
Ventricular enlargement is one of the most consistent abnormal structural brain findings in schizophrenia and has been used to infer brain shrinkage. However, whether ventricular enlargement is related to local overlying cortex and/or adjacent subcortical structures or whether it is related to brain volume change globally has not been assessed. We systematically assessed interrelations of ventricular volumes with gray and white matter volumes of 40 Brodmann areas (BAs), the thalamus and its medial dorsal nucleus and pulvinar, the internal capsule, caudate and putamen. We acquired structural MRI ( patients with schizophrenia (n = 64) and healthy controls (n = 56)) and diffusion tensor fractional anisotropy (FA) (untreated schizophrenia n = 19, controls n = 32). Volumes were assessed by manual tracing of central structures and a semi-automated parcellation of BAs. Patients with schizophrenia had increased ventricular size associated with decreased cortical gray matter volumes widely across the brain; a similar but less pronounced pattern was seen in normal controls; local correlations (e.g. temporal horn with temporal lobe volume) were not appreciably higher than non-local correlations (e.g. temporal horn with prefrontal volume). White matter regions adjacent to the ventricles similarly did not reveal strong regional relationships. FA and center of mass of the anterior limb of the internal capsule also appeared differentially influenced by ventricular volume but findings were similarly not regional. Taken together, these findings indicate that ventricular enlargement is globally interrelated with gray matter volume diminution but not directly correlated with volume loss in the immediately adjacent caudate, putamen, or internal capsule.
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Affiliation(s)
- Guillermo Horga
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
- Schizophrenia Clinic Program, Department of Psychiatry, Hospital Clínic Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Javier Bernacer
- Laboratory of Functional Neuromorphology, Clinica Universitaria, Universidad de Navarra, Avda. Pío XII 36, 31008 Pamplona, Spain
| | - Nicola Dusi
- Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Policlinico Giambattista Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Jonathan Entis
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
| | - Kingwai Chu
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
| | - Erin A. Hazlett
- Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, 10468 Bronx, NY USA
| | - M. Mehmet Haznedar
- Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, 10468 Bronx, NY USA
| | - Eileen Kemether
- Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, 10029 New York, NY USA
| | - William Byne
- Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, 10468 Bronx, NY USA
| | - Monte S. Buchsbaum
- Departments of Psychiatry and Radiology, NeuroPET Center, University of California, 11388 Sorrento Valley Road, Suite #100, 92121 San Diego, CA USA
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12
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Yang Y, Nuechterlein KH, Phillips O, Hamilton LS, Subotnik KL, Asarnow RF, Toga AW, Narr KL. The contributions of disease and genetic factors towards regional cortical thinning in schizophrenia: the UCLA family study. Schizophr Res 2010; 123:116-25. [PMID: 20817413 PMCID: PMC2988766 DOI: 10.1016/j.schres.2010.08.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 07/27/2010] [Accepted: 08/03/2010] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Cortical thickness reductions in prefrontal and temporal cortices have been repeatedly observed in patients with schizophrenia. However, it remains unclear whether regional variations in cortical thickness may be attributable to disease-related or genetic-liability factors. METHOD The structural magnetic resonance imaging data of 48 adult-onset schizophrenia patients, 66 first-degree non-psychotic relatives of schizophrenia patients, 27 community comparison (CC) probands and 77 CC relatives were examined using cortical pattern matching methods to map and compare highly localized changes in cortical gray matter thickness between groups defined by biological risk for schizophrenia. RESULTS Schizophrenia patients showed marked cortical thinning primarily in frontal and temporal cortices when compared to unrelated CC probands. Results were similar, though less pronounced when patients were compared with their non-psychotic relatives. Cortical thickness reductions observed in unaffected relatives compared to age-similar CC relatives suggestive of schizophrenia-related genetic liability were marginal, surviving correction for the left parahippocampal gyrus and inferior occipital cortex only. CONCLUSIONS Observations of pronounced fronto/temporal cortical thinning in schizophrenia patients replicate prior findings. The lack of marked cortical thickness alterations in non-psychotic relatives of patients, suggests that disease processes are primary contributors toward cortical thickness reductions in the disorder. However, genetic factors may have a larger influence on abnormalities in the medial temporal lobe.
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Affiliation(s)
- Yaling Yang
- Laboratory of Neuro Imaging, Geffen School of Medicine at UCLA, Los Angeles, CA 90024, United States.
| | - Keith H. Nuechterlein
- Department of Psychology, UCLA, Los Angeles, CA
,The Jane & Terry Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Owen Phillips
- Laboratory of Neuro Imaging, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Liberty S. Hamilton
- Laboratory of Neuro Imaging, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Kenneth L. Subotnik
- The Jane & Terry Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Robert F. Asarnow
- Department of Psychology, UCLA, Los Angeles, CA
,The Jane & Terry Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Katherine L. Narr
- Laboratory of Neuro Imaging, Geffen School of Medicine at UCLA, Los Angeles, CA
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13
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Crespo-Facorro B, Roiz-Santiáñez R, Pérez-Iglesias R, Tordesillas-Gutiérrez D, Mata I, Rodríguez-Sánchez JM, de Lucas EM, Vázquez-Barquero JL. Specific brain structural abnormalities in first-episode schizophrenia. A comparative study with patients with schizophreniform disorder, non-schizophrenic non-affective psychoses and healthy volunteers. Schizophr Res 2009; 115:191-201. [PMID: 19796919 DOI: 10.1016/j.schres.2009.09.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 08/26/2009] [Accepted: 09/07/2009] [Indexed: 12/31/2022]
Abstract
Evidence so far indicates the consistent association between brain structural abnormalities and schizophrenia already present at the early phases of the illness. This study investigates the specificity of brain structural abnormalities in schizophrenia by using region-of-interest method of volumetric analysis in a heterogeneous sample of schizophrenia spectrum patients at their first break of the illness. 225 subjects, comprising 82 schizophrenia patients, 36 schizophreniform disorder patients and 24 patients with non-schizophrenic non-affective psychoses, and 83 healthy individuals underwent a magnetic resonance imaging brain scan. Quantitative brain morphometric variables were assessed: cortical CSF, lateral ventricle, total brain tissue, white matter and cortical and subcortical gray matter volumes. The contribution of sociodemographic, cognitive and clinical characteristics was controlled. Compared with controls, schizophrenia (P=0.017) and schizophreniform disorder (P=0.023) patients showed an increase in cortical CSF volume. Schizophrenia patients had also markedly enlarged lateral ventricle volume compared to controls (P=0.026). The patients with non-schizophrenic non-affective psychoses did not significantly differ in lateral ventricle and cortical CSF volumes from controls. Compared with controls, schizophrenia and schizophreniform disorder patients demonstrated a significant decrease in total brain tissue (-1.30% and -1.12% respectively). Thalamic volume was reduced (-3.84%) in schizophrenia patients compared to controls (P=0.040). Clinical and cognitive variables were not significantly related with morphological changes. The brain changes found in patients with a first episode of schizophrenia spectrum disorders are robustly associated with the diagnoses of schizophrenia and schizophreniform disorder and are independent of relevant intervening variables.
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Affiliation(s)
- Benedicto Crespo-Facorro
- Department of Psychiatry, University Hospital Marqués de Valdecilla, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain.
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14
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Bersani G, Quartini A, Manuali G, Iannitelli A, Pucci D, Conforti F, Di Biasi C, Gualdi G. Influence of obstetric complication severity on brain morphology in schizophrenia: an MR study. Neuroradiology 2009; 51:363-71. [PMID: 19214492 DOI: 10.1007/s00234-009-0501-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 01/20/2009] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The purpose of this study was to determine if a causal relationship exists between obstetric complications (OCs) severity and linear magnetic resonance (MR) measurements of brain atrophy in patients with schizophrenia. MATERIALS AND METHODS Linear measurements of ventricular enlargement (bifrontal span, Evans ratio, and bicaudate ratio) and hippocampal atrophy (interuncal distance) were completed on MR images obtained in 47 patients with schizophrenia. Regression analysis was used to look at association with OCs severity, assessed by the "Midwife protocol" of Parnas and colleagues. The relationship between MR measurements and phenomenologic variables such as age at onset, illness duration, and exposure to antipsychotic medications was explored. The relationship between MR measurements, OCs severity, and symptom presentation was also investigated. RESULTS OCs severity was significantly associated with MR measurements of ventricular enlargement (bifrontal span, Evans ratio). As the severity of OCs increased, bifrontal span and Evans ratio increased. This effect was independent of age at onset, illness duration, or even antipsychotic treatment. Interestingly, bifrontal span, Evans ratio, and OCs severity score all showed a significant positive correlation with hallucinatory symptomatology. CONCLUSION Although confirmatory studies are needed, our findings would support the idea that environmental factors, in this case severe OCs, might partly contribute to ventricular abnormalities in schizophrenia.
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Affiliation(s)
- G Bersani
- Department of Psychiatric Sciences and Psychological Medicine, Sapienza University of Rome, Polo Pontino, Via di Torre Argentina, 21, Rome, 00186, Italy.
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15
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Mean diffusivity: a biomarker for CSF-related disease and genetic liability effects in schizophrenia. Psychiatry Res 2009; 171:20-32. [PMID: 19081707 PMCID: PMC2665171 DOI: 10.1016/j.pscychresns.2008.03.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Revised: 03/19/2008] [Accepted: 03/19/2008] [Indexed: 11/20/2022]
Abstract
Mean diffusivity (MD), the rotationally invariant magnitude of water diffusion that is greater in cerebrospinal fluid (CSF) and smaller in organized brain tissue, has been suggested to reflect schizophrenia-associated cortical atrophy. Regional changes, associations with CSF, and the effects of genetic predisposition towards schizophrenia, however, remain uncertain. Six-direction diffusion tensor imaging DTI and high-resolution structural images were obtained from 26 schizophrenia patients, 36 unaffected first-degree patient relatives, 20 control subjects and 32 control relatives (N=114). Registration procedures aligned diffusion tensor imaging (DTI) data across imaging modalities. MD was averaged within lobar regions and the cingulate and superior temporal gyri. CSF volume and MD were highly correlated. Significant bilateral temporal, and superior temporal MD increases were observed in schizophrenia compared with unrelated control probands. First-degree relatives of schizophrenia probands showed larger MD measures compared with controls within bilateral superior temporal regions with CSF volume correction. Superior temporal lobe brain tissue deficits and proximal CSF enlargements are widely documented in schizophrenia. Larger MD indices in patients and their relatives may thus reflect similar pathophysiological mechanisms. However, persistence of regional MD effects after controlling for CSF volume, suggests that MD is a sensitive biological marker of disease and genetic liability, characterizing at least partially distinct aspects of brain structural integrity.
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16
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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: 40] [Impact Index Per Article: 2.7] [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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17
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Three-dimensional mapping of the lateral ventricles in autism. Psychiatry Res 2008; 163:106-15. [PMID: 18502618 PMCID: PMC2770439 DOI: 10.1016/j.pscychresns.2007.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Revised: 10/22/2007] [Accepted: 11/07/2007] [Indexed: 11/23/2022]
Abstract
In this study, a computational mapping technique was used to examine the three-dimensional profile of the lateral ventricles in autism. T1-weighted three-dimensional magnetic resonance images of the brain were acquired from 20 males with autism (age: 10.1+/-3.5 years) and 22 male control subjects (age: 10.7+/-2.5 years). The lateral ventricles were delineated manually and ventricular volumes were compared between the two groups. Ventricular traces were also converted into statistical three-dimensional maps, based on anatomical surface meshes. These maps were used to visualize regional morphological differences in the thickness of the lateral ventricles between patients and controls. Although ventricular volumes measured using traditional methods did not differ significantly between groups, statistical surface maps revealed subtle, highly localized reductions in ventricular size in patients with autism in the left frontal and occipital horns. These localized reductions in the lateral ventricles may result from exaggerated brain growth early in life.
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18
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Gunduz-Bruce H, Narr KL, Gueorguieva R, Toga AW, Szeszko PR, Ashtari M, Robinson DG, Sevy S, Kane JM, Bilder RM. CSF sub-compartments in relation to plasma osmolality in healthy controls and in patients with first episode schizophrenia. Psychiatry Res 2007; 155:57-66. [PMID: 17398079 PMCID: PMC3299193 DOI: 10.1016/j.pscychresns.2006.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Revised: 12/12/2006] [Accepted: 12/14/2006] [Indexed: 11/28/2022]
Abstract
Preliminary evidence suggests that plasma Na(+) level/osmolality may have effects on brain morphology; thus we investigated the link between plasma osmolality and ventricle size in healthy controls and patients with first episode schizophrenia. A total of 16 patients and 28 healthy controls were examined with magnetic resonance imaging (MRI) and gave blood samples. High-resolution 3D SPGR images were obtained on a 1.5 Tesla scanner. Scalp-edited MRI volumes were used for estimates of intracranial gray, white matter and CSF. Regional changes in CSF concentration and ventricular morphology were measured. The groups did not differ in plasma osmolality, but patients had higher plasma Na(+). There were no differences in ventricle size. Controlling for plasma osmolality did not change the results. A mixed model procedure indicated a significant group effect and a significant osmolality by group interaction in ventricle measures. Healthy control group showed a significant relationship between osmolality and ventricle measures; this relationship was absent in the patients. Significant correlations between osmolality and lateral ventricle surface deformations were observed along the superior horn of the lateral ventricles in the healthy controls. These results suggest that plasma osmolality is related to ventricle size in healthy volunteers and that this physiological link is impaired in patients with first episode schizophrenia.
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Affiliation(s)
- Handan Gunduz-Bruce
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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19
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Buckley PF, Pillai A, Evans D, Stirewalt E, Mahadik S. Brain derived neurotropic factor in first-episode psychosis. Schizophr Res 2007; 91:1-5. [PMID: 17306505 PMCID: PMC1933504 DOI: 10.1016/j.schres.2006.12.026] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Revised: 12/21/2006] [Accepted: 12/27/2006] [Indexed: 12/22/2022]
Abstract
There is much interest, derived from current neurochemical, genetic, and therapeutic research, in the role of brain neurotrophins in schizophrenia. Neurotrophins play key roles in neuronal development and differentiation (i.e., promoting dendritogenesis and synaptogenesis), and in orchestrating the neuronal response to stress/noxious stimuli. Additionally, neurotrophins are modulators across monominergic (dopamine and serotonin), gabaergic and cholinergic systems. These roles focus on important areas of the etiopathophysiology of schizophrenia. Clinical studies show reductions in brain-derived neurotrophic factor (BDNF) and nerve growth factor (NFG) in schizophrenic patients as compared to normal control subjects, as well as differences in patients receiving first-generation antipsychotics (FGAs) or second-generation antipsychotics (SGAs). We now report on BDNF levels in subjects with first-episode psychosis in comparison with normal healthy controls. Compared to normal controls (N=14; 290.5+/-38.81 pg/ml), first-episode psychotic patients showed significant reduction (N=15; 135+/-21.77 pg/ml; P=0.001; f=12.873) in plasma BDNF. Additionally, plasma BDNF levels showed a significant negative correlation (N=13' r=0.584, P=0.0362) only with positive symptom scores at base line and no significant correlations were found with any of the cognitive performance test battery or motor function test scores. Low BDNF levels at the onset of psychosis suggest that it may contribute to the pathogenesis of schizophrenia and/or perhaps could be a helpful neurobiological marker for possible early treatment intervention.
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Affiliation(s)
- Peter F Buckley
- Department of Psychiatry and Health Behavior, School of Medicine, Medical College of Georgia, Augusta, GA 30912, USA.
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