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Miller BJ, Herzig KH, Jokelainen J, Karhu T, Keinänen-Kiukaanniemi S, Järvelin MR, Veijola J, Viinamäki H, Päivikki Tanskanen, Jääskeläinen E, Isohanni M, Timonen M. Inflammation, hippocampal volume, and cognition in schizophrenia: results from the Northern Finland Birth Cohort 1966. Eur Arch Psychiatry Clin Neurosci 2021; 271:609-622. [PMID: 32382794 DOI: 10.1007/s00406-020-01134-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/27/2020] [Indexed: 02/08/2023]
Abstract
Increased blood interleukin-6 (IL-6) levels are a replicated abnormality in schizophrenia, and may be associated with smaller hippocampal volumes and greater cognitive impairment. These findings have not been investigated in a population-based birth cohort. The general population Northern Finland Birth Cohort 1966 was followed until age 43. Subjects with schizophrenia were identified through the national Finnish Care Register. Blood IL-6 levels were measured in n = 82 subjects with schizophrenia and n = 5373 controls at age 31. Additionally, 31 patients with schizophrenia and 63 healthy controls underwent brain structural MRI at age 34, and cognitive testing at ages 34 and 43. Patients with schizophrenia had significantly higher median (interquartile range) blood IL-6 levels than controls (5.31, 0.85-17.20, versus 2.42, 0.54-9.36, p = 0.02) after controlling for potential confounding factors. In both schizophrenia and controls, higher blood IL-6 levels were predictors of smaller hippocampal volumes, but not cognitive performance at age 34. We found evidence for increased IL-6 levels in patients with midlife schizophrenia from a population-based birth cohort, and replicated associations between IL-6 levels and hippocampal volumes. Our results complement and extend the previous findings, providing additional evidence that IL-6 may play a role in the pathophysiology of schizophrenia and associated brain alterations.
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Affiliation(s)
- Brian J Miller
- Department of Psychiatry and Health Behavior, Augusta University, 997 Saint Sebastian Way, Augusta, GA, 30912, USA.
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
| | - Jari Jokelainen
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Toni Karhu
- Research Unit of Biomedicine, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Juha Veijola
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Heimo Viinamäki
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | | | - Erika Jääskeläinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Matti Isohanni
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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van Haren N, Cahn W, Hulshoff Pol H, Kahn R. Schizophrenia as a progressive brain disease. Eur Psychiatry 2020; 23:245-54. [DOI: 10.1016/j.eurpsy.2007.10.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 10/11/2007] [Accepted: 10/18/2007] [Indexed: 01/06/2023] Open
Abstract
AbstractThere is convincing evidence that schizophrenia is characterized by abnormalities in brain volume. At the Department of Psychiatry of the University Medical Centre Utrecht, Netherlands, we have been carrying out neuroimaging studies in schizophrenia since 1995. We focused our research on three main questions. First, are brain volume abnormalities static or progressive in nature? Secondly, can brain volume abnormalities in schizophrenia be explained (in part) by genetic influences? Finally, what environmental factors are associated with the brain volume abnormalities in schizophrenia?Based on our findings we suggest that schizophrenia is a progressive brain disease. We showed different age-related trajectories of brain tissue loss suggesting that brain maturation that occurs in the third and fourth decade of life is abnormal in schizophrenia. Moreover, brain volume has been shown to be a useful phenotype for studying schizophrenia. Brain volume is highly heritable and twin and family studies show that unaffected relatives show abnormalities that are similar, but usually present to a lesser extent, to those found in the patients. However, also environmental factors play a role. Medication intake is indeed a confounding factor when interpreting brain volume (change) abnormalities, while independent of antipsychotic medication intake brain volume abnormalities appear influenced by the outcome of the illness.In conclusion, schizophrenia can be considered as a progressive brain disease with brain volume abnormalities that are for a large part influenced by genetic factors. Whether the progressive volume change is also mediated by genes awaits the results of longitudinal twin analyses. One of the main challenges for the coming years, however, will be the search for gene-by-environment interactions on the progressive brain changes in schizophrenia.
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Tang X, Lyu G, Chen M, Huang W, Lin Y. Amygdalar and Hippocampal Morphometry Abnormalities in First-Episode Schizophrenia Using Deformation-Based Shape Analysis. Front Psychiatry 2020; 11:677. [PMID: 32765318 PMCID: PMC7379331 DOI: 10.3389/fpsyt.2020.00677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 06/29/2020] [Indexed: 11/14/2022] Open
Abstract
In this study, we investigated and quantified the amygdalar and hippocampal morphometry abnormalities exerted by first-episode schizophrenia using a total of 92 patients and 106 healthy control participants. Magnetic resonance imaging (MRI) based automated segmentation was conducted to obtain the amygdalar and hippocampal segmentations. Disease-versus-control volume differences of the bilateral amygdalas and hippocampi were quantified. In addition, deformation-based statistical shape analysis was employed to quantify the region-specific shape abnormalities of each structure of interest. To better identify the key relevant areas in the pathology of first-episode schizophrenia, each structure was divided into four subregions; CA1, CA2, CA3 combined with dentate gyrus for the hippocampus in each hemisphere and basolateral, basomedial, centromedial, and lateral nucleus for the amygdala in each hemisphere. We observed significant global volume reduction and localized shape atrophy in each of the four structures of interest. The amygdalar shape abnormalities mainly occurred at the basolateral and centromedial subregions, whereas the hippocampal shape abnormalities mainly concentrated on the CA1 and CA2 subregions. For the same structure, the one on the right hemisphere was affected more by the disease pathology than that on the left hemisphere. To conclude, we have successfully quantified the global and local morphometric abnormalities of the bilateral amygdalas and hippocampi using a sophisticated statistical analysis pipeline and high-field subregion segmentations, with MRI data of a considerable sample size. This study is one of the very first of such kind in first-episode schizophrenia analyses.
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Affiliation(s)
- Xiaoying Tang
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Guiwen Lyu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Minhua Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China.,Department of Electrical and Electronic Engineering, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, China
| | - Weikai Huang
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Yin Lin
- Department of Psychology, Shenzhen Children's Hospital, Shenzhen, China
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Lundemose S, Busch JR, Møller M, Jensen KE, Lynnerup N, Banner J, Jacobsen C. Comparison of hippocampal volume measurement by autopsy and post-mortem magnetic resonance imaging. Forensic Sci Med Pathol 2019; 16:119-122. [PMID: 31667731 DOI: 10.1007/s12024-019-00188-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2019] [Indexed: 11/25/2022]
Abstract
We present an autopsy-validated, non-invasive, magnetic resonance imaging (MRI) based segmentation algorithm, for determining hippocampal volume. A segmentation algorithm was developed to assess the volume of the hippocampus. Deceased individuals with severe mental illness were used to evaluate the use of MRI imaging to determine hippocampal volume as this group has previously been associated with altered hippocampal volume diagnosed on MRI. The accuracy of the MR- scanning protocol for volume measurement was tested on a water filled phantom control with a known volume of 500 ml, and a difference of 0.08% was found. Thus the scanning protocol was deemed to have produced acceptable results when comparing volume measures of a pair of segmented hippocampi obtained at the 1 T MR scanner and a 3 T MR scanner using the software program Mimics®. The segmentation algorithm was tested by a volume comparison obtained using anterior and posterior landmarks (in situ) and the exact volume of the dissected hippocampus (ex situ). The in situ and ex situ hippocampal volumes were highly correlated; R2 was 96%, with a mean difference of 4-5%. Cases were also examined for intra- and inter-observer agreement. This study presents a validated segmentation algorithm that can be used to determine the hippocampal volume using post-mortem MR and anatomical landmarks.
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Affiliation(s)
- Sissel Lundemose
- Department of Forensic Pathology, Institute of Forensic Medicine, University of Copenhagen, Frederik V's vej 11, 2100, Copenhagen East, Denmark.
- , Copenhagen East, Denmark.
| | - Johannes Rødbro Busch
- Department of Forensic Pathology, Institute of Forensic Medicine, University of Copenhagen, Frederik V's vej 11, 2100, Copenhagen East, Denmark
| | - Morten Møller
- Department of Neuroscience, Panum Institute 24.6.06, University of Copenhagen, Blegdamsvej3B, 2200, Copenhagen, Denmark
| | - Karl-Erik Jensen
- Radiology Clinic Valby, Toftegaards Allé 7, 2500, Copenhagen, Denmark
| | - Niels Lynnerup
- Department of Forensic Pathology, Institute of Forensic Medicine, University of Copenhagen, Frederik V's vej 11, 2100, Copenhagen East, Denmark
| | - Jytte Banner
- Department of Forensic Pathology, Institute of Forensic Medicine, University of Copenhagen, Frederik V's vej 11, 2100, Copenhagen East, Denmark
| | - Christina Jacobsen
- Department of Forensic Pathology, Institute of Forensic Medicine, University of Copenhagen, Frederik V's vej 11, 2100, Copenhagen East, Denmark
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Cahn W, Hulshoff Pol HE, Bongers M, Schnack HG, Mandl RCW, Van Haren NEM, Durston S, Koning H, Van Der Linden JA, Kahn RS. Brain morphology in antipsychotic-naïve schizophrenia: A study of multiple brain structures. Br J Psychiatry 2018; 43:s66-72. [PMID: 12271803 DOI: 10.1192/bjp.181.43.s66] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BackgroundAlthough brain volume changes are found in schizophrenia, only a limited number of structural magnetic resonance imaging studies have exclusively examined antipsychotic-naïve patients.AimsTo comprehensively investigate multiple brain structures in a single sample of patients who were antipsychotic-naïve.MethodTwenty antipsychotic-naïve patients with first-episode schizophrenia and 20 healthy comparison subjects were included. Intracranial, total brain, frontal lobe, grey and white matter, cerebellar, hippocampal, parahippocampal, thalamic, caudate nucleus and lateral and third ventricular volumes were measured. Repeated-measures analyses of (co)variance were conducted with intracranial volume as covariate.ResultsThird ventricle volume enlargement was found in patients compared with the healthy subjects. No differences were found in other brain regions.ConclusionsThese findings suggest that some brain abnormalities are present in the early stages of schizophrenia. Moreover, it suggests that brain abnormalities reported in patients with chronic schizophrenia develop in a later stage of the disease and/or are medication induced.
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Affiliation(s)
- W Cahn
- Department of Psychiatry, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
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6
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Kalmady SV, Shivakumar V, Arasappa R, Subramaniam A, Gautham S, Venkatasubramanian G, Gangadhar BN. Clinical correlates of hippocampus volume and shape in antipsychotic-naïve schizophrenia. Psychiatry Res Neuroimaging 2017; 263:93-102. [PMID: 28371658 DOI: 10.1016/j.pscychresns.2017.03.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 03/09/2017] [Accepted: 03/20/2017] [Indexed: 01/25/2023]
Abstract
While volume deficit of hippocampus is an established finding in schizophrenia, very few studies have examined large sample of patients without the confounding effect of antipsychotic treatment. Concurrent evaluation of hippocampus shape will offer additional information on the hippocampal aberrations in schizophrenia. In this study, we analyzed the volume and shape of hippocampus in antipsychotic-naïve schizophrenia patients (N=71) in comparison to healthy controls (N=82). Using 3-T MRI data, gray matter (GM) volume (anterior and posterior sub-divisions) and shape of the hippocampus were analyzed. Schizophrenia patients had significant hippocampal GM volume deficits (specifically the anterior sub-division) in comparison to healthy controls. There were significant positive correlations between anterior hippocampus volume and psychopathology scores of positive syndrome. Shape analyses revealed significant inward deformation of bilateral hippocampal surface in patients. In conclusion, our study findings add robust support for volume deficit in hippocampus in antipsychotic-naïve schizophrenia. Hippocampal shape deficits in schizophrenia observed in this study map to anterior CA1 sub-region. The differential relationship of anterior hippocampus (but not posterior hippocampus) with clinical symptoms is in tune with the findings in animal models. Further systematic studies are needed to evaluate the relationship between these hippocampal gray matter deficits with white matter and functional connectivity to facilitate understanding the hippocampal network abnormalities in schizophrenia.
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Affiliation(s)
- Sunil Vasu Kalmady
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Rashmi Arasappa
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Aditi Subramaniam
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - S Gautham
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
| | - Bangalore N Gangadhar
- The Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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7
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Kalmady SV, Shivakumar V, Gautham S, Arasappa R, Jose DA, Venkatasubramanian G, Gangadhar BN. Dermatoglyphic correlates of hippocampus volume: Evaluation of aberrant neurodevelopmental markers in antipsychotic-naïve schizophrenia. Psychiatry Res 2015; 234:113-20. [PMID: 26385539 DOI: 10.1016/j.pscychresns.2015.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 07/23/2015] [Accepted: 09/02/2015] [Indexed: 12/31/2022]
Abstract
Schizophrenia is a disorder of aberrant neurodevelopment is marked by abnormalities in brain structure and dermatoglyphic traits. However, the link between these two (i.e. dermatoglyphic parameters and brain structure) which share ectodermal origin and common developmental window has not been explored extensively. The current study examined dermatoglyphic correlates of hippocampal volume in antipsychotic-naïve schizophrenia patients in comparison with matched healthy controls. Ridge counts and asymmetry measures for palmar inter-digital areas (a-b, b-c, c-d) were obtained using high resolution digital scans of palms from 89 schizophrenia patients [M:F=48:41] and 48 healthy controls [M:F=30:18]. Brain scans were obtained for subset of subjects including 26 antipsychotic-naïve patients [M:F=13:13] and 29 healthy controls [M:F=19:10] using 3 T-MRI. Hippocampal volume and palmar ridge counts were measured by blinded raters with good inter-rater reliability using valid methods. Directional asymmetry (DA) of b-c and bilateral hippocampal volume were significantly lower in patients than controls. Significant positive correlation was found between DA and ridge count of b-c with bilateral anterior hippocampal volume. Study demonstrates the utility of dermatoglyphic markers in identifying structural changes in the brain which may form the basis for neurodevelopmental pathogenesis in schizophrenia.
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Affiliation(s)
- Sunil V Kalmady
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, NIMHANS, Bangalore, India
| | - Venkataram Shivakumar
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, NIMHANS, Bangalore, India
| | - S Gautham
- Translational Psychiatry Laboratory, Neurobiology Research Centre, NIMHANS, Bangalore, India
| | - Rashmi Arasappa
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, NIMHANS, Bangalore, India
| | - Dania A Jose
- Translational Psychiatry Laboratory, Neurobiology Research Centre, NIMHANS, Bangalore, India
| | - Ganesan Venkatasubramanian
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, NIMHANS, Bangalore, India.
| | - B N Gangadhar
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, NIMHANS, Bangalore, India
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8
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Yang C, Wu S, Lu W, Bai Y, Gao H. Brain differences in first-episode schizophrenia treated with quetiapine: a deformation-based morphometric study. Psychopharmacology (Berl) 2015; 232:369-77. [PMID: 25080851 DOI: 10.1007/s00213-014-3670-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 06/24/2014] [Indexed: 02/02/2023]
Abstract
RATIONALE With the development of various imaging techniques, the deformation-based morphometry (DBM) method provides an objective automatic examination of the whole brain. OBJECTIVES This study aims to assess the abnormalities in the brains of first-episode schizophrenia (FES) patients treated with quetiapine using another advanced nonrigid registration method, hierarchical attribute matching mechanism for elastic registration, through the application of DBM in the entire brain. METHODS Thirty FES patients and 30 normal controls were grouped by age and handedness and subjected to magnetic resonance imaging examination. The patients had relatively short durations of untreated psychosis (DUP; 6.4 ± 5.2 months), and only a single antipsychotic drug, quetiapine (dosage, 200 ± 75 mg), was used for treatment. Statistically significant changes in regional volume were analyzed via DBM. In addition, a voxel-wise analysis of correlations between the duration of treatment or dosage and volume was also performed. RESULTS Compared with control subjects, FES patients showed contracted regions located in Brodmann area (BA) 42 and BA 19. By contrast, expanded regions were observed in BA 38, BA 21, BA 6 and 8, and left cerebellum. A negative correlation was observed between dosage and volume in the hippocampus, while a positive correlation was found in the caudate. Meanwhile, a negative correlation was observed between duration of treatment and volume in BA 38. CONCLUSION Both regional volume reductions and increases were detected in the brains of FES patients treated with quetiapine compared with healthy control subjects. Such differences may be partially relevant to dosage and treatment duration in clinic.
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Affiliation(s)
- Chunlan Yang
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, 100022, China
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Premkumar P, Sharma T. Neuropsychologic functioning and structural MRI of the brain in patients with schizophrenia. Expert Rev Neurother 2014; 5:85-94. [PMID: 15853478 DOI: 10.1586/14737175.5.1.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The first episode of schizophrenia represents a transition from a premorbid to a morbid state. Studying the first episode of schizophrenia is useful since it is devoid of the confounds of chronicity and long-term medication. It is also likely to direct us to the core deficits of the illness. Studies on first-episode schizophrenia suggest a generalized neuropsychologic impairment, but that memory, attention and executive function are more severely impaired. Support for a neurodevelopmental model of neuropsychologic impairment in schizophrenia is derived from the findings that much of the neuropsychologic impairment is present by illness onset, that neuropsychologic impairment remains stable over time and that there is a weak relation between duration of untreated psychosis and neuropsychologic impairment. However, neuropsychologic impairment is moderated by neuroleptic treatment, with some evidence that atypical antipsychotics may have some beneficial effects over conventional antipsychotics. The causal mechanisms of brain abnormality in the temporal and frontal lobes appear to be different to that of neuropsychologic impairment in schizophrenia. The observation that there is a brain volume decrement over time and that the rate of change is higher during the first 5 years would be consistent with a neurodegenerative model of schizophrenia. At the same time, the basal ganglia are vulnerable to volumetric increase secondary to neuroleptic medication. Understanding the roles of the neurodevelopmental and neurodegenerative models of schizophrenia is important in deciding intervention strategies.
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Pepe A, Zhao L, Koikkalainen J, Hietala J, Ruotsalainen U, Tohka J. Automatic statistical shape analysis of cerebral asymmetry in 3D T1-weighted magnetic resonance images at vertex-level: application to neuroleptic-naïve schizophrenia. Magn Reson Imaging 2013; 31:676-87. [PMID: 23337078 DOI: 10.1016/j.mri.2012.10.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/30/2012] [Accepted: 10/30/2012] [Indexed: 12/13/2022]
Abstract
The study of the structural asymmetries in the human brain can assist the early diagnosis and progression of various neuropsychiatric disorders, and give insights into the biological bases of several cognitive deficits. The high inter-subject variability in cortical morphology complicates the detection of abnormal asymmetries especially if only small samples are available. This work introduces a novel automatic method for the local (vertex-level) statistical shape analysis of gross cerebral hemispheric surface asymmetries which is robust to the individual cortical variations. After segmentation of the cerebral hemispheric volumes from three-dimensional (3D) T1-weighted magnetic resonance images (MRI) and their spatial normalization to a common space, the right hemispheric masks were reflected to match with the left ones. Cerebral hemispheric surfaces were extracted using a deformable model-based algorithm which extracted the salient morphological features while establishing the point correspondence between the surfaces. The interhemispheric asymmetry, quantified by customized measures of asymmetry, was evaluated in a few thousands of corresponding surface vertices and tested for statistical significance. The developed method was tested on scans obtained from a small sample of healthy volunteers and first-episode neuroleptic-naïve schizophrenics. A significant main effect of the disease on the local interhemispheric asymmetry was observed, both in females and males, at the frontal and temporal lobes, the latter being often linked to the cognitive, auditory, and memory deficits in schizophrenia. The findings of this study, although need further testing in larger samples, partially replicate previous studies supporting the hypothesis of schizophrenia as a neurodevelopmental disorder.
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Affiliation(s)
- Antonietta Pepe
- Department of Signal Processing, Tampere University of Technology, PO Box 553, FIN-33101 Tampere, Finland.
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11
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Ebdrup BH, Glenthøj B, Rasmussen H, Aggernaes B, Langkilde AR, Paulson OB, Lublin H, Skimminge A, Baaré W. Hippocampal and caudate volume reductions in antipsychotic-naive first-episode schizophrenia. J Psychiatry Neurosci 2010; 35:95-104. [PMID: 20184807 PMCID: PMC2834791 DOI: 10.1503/jpn.090049] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Enlarged ventricles and reduced hippocampal volume are consistently found in patients with first-episode schizophrenia. Studies investigating brain structure in antipsychotic-naive patients have generally focused on the striatum. In this study, we examined whether ventricular enlargement and hippocampal and caudate volume reductions are morphological traits of antipsychotic-naive first-episode schizophrenia. METHODS We obtained high-resolution 3-dimensional T1-weighted magnetic resonance imaging scans for 38 antipsychotic-naive first-episode schizophrenia patients and 43 matched healthy controls by use of a 3-T scanner. We warped the brain images to each other by use of a high-dimensional intersubject registration algorithm. We performed voxel-wise group comparisons with permutation tests. We performed small volume correction for the hippocampus, caudate and ventricles by use of a false discovery rate correction (p < 0.05) to control for multiple comparisons. We derived and analyzed estimates of brain structure volumes. We grouped patients as those with (n = 9) or without (n = 29) any lifetime substance abuse to examine the possible effects of substance abuse. RESULTS We found that hippocampal and caudate volumes were decreased in patients with first-episode schizophrenia. We found no ventricular enlargement, differences in global volume or significant associations between tissue volume and duration of untreated illness or psychopathology. The hippocampal volume reductions appeared to be influenced by a history of substance abuse. Exploratory analyses indicated reduced volume of the nucleus accumbens in patients with first-episode schizophrenia. LIMITATIONS This study was not a priori designed to test for differences between schizophrenia patients with or without lifetime substance abuse, and this subgroup was small. CONCLUSION Reductions in hippocampal and caudate volume may constitute morphological traits in antipsychotic-naive first-episode schizophrenia patients. However, the clinical implications of these findings are unclear. Moreover, past substance abuse may accentuate hippocampal volume reduction. Magnetic resonance imaging studies addressing the potential effects of substance abuse in antipsychotic-naive first-episode schizophrenia patients are warranted.
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Affiliation(s)
- Bjørn H. Ebdrup
- Correspondence to: Dr. B.H. Ebdrup, Center for Neuropsychiatric Schizophrenia Research, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Psychiatric Center Glostrup, University Hospital Glostrup, DK-2600 Glostrup, Denmark; fax 45 4323 4653;
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12
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Zhao L, Ruotsalainen U, Hirvonen J, Hietala J, Tohka J. Automatic cerebral and cerebellar hemisphere segmentation in 3D MRI: adaptive disconnection algorithm. Med Image Anal 2010; 14:360-72. [PMID: 20303318 DOI: 10.1016/j.media.2010.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 09/17/2009] [Accepted: 02/01/2010] [Indexed: 12/14/2022]
Abstract
This paper describes the automatic Adaptive Disconnection method to segment cerebral and cerebellar hemispheres of human brain in three-dimensional magnetic resonance imaging (MRI). Using the partial differential equations based shape bottlenecks algorithm cooperating with an information potential value clustering process, it detects and cuts, first, the compartmental connections between the cerebrum, the cerebellum and the brainstem in the white matter domain, and then, the interhemispheric connections of the extracted cerebrum and cerebellum volumes. As long as the subject orientation in the scanner is given, the variations in subject location and normal brain morphology in different images are accommodated automatically, thus no stereotaxic image registration is required. The modeling of partial volume effect is used to locate cerebrum, cerebellum and brainstem boundaries, and make the interhemispheric connections detectable. The Adaptive Disconnection method was tested with 10 simulated images from the BrainWeb database and 39 clinical images from the LONI Probabilistic Brain Atlas database. It obtained lower error rates than a traditional shape bottlenecks algorithm based segmentation technique (BrainVisa) and linear and nonlinear registration based brain hemisphere segmentation methods. Segmentation accuracies were evaluated against manual segmentations. The Adaptive Disconnection method was also confirmed not to be sensitive to the noise and intensity non-uniformity in the images. We also applied the Adaptive Disconnection method to clinical images of 22 healthy controls and 18 patients with schizophrenia. A preliminary cerebral volumetric asymmetry analysis based on these images demonstrated that the Adaptive Disconnection method is applicable to study abnormal brain asymmetry in schizophrenia.
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Affiliation(s)
- Lu Zhao
- Department of Signal Processing, Tampere University of Technology, P.O. Box 553, FIN-33101 Tampere, Finland
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13
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Levitt JJ, Bobrow L, Lucia D, Srinivasan P. A selective review of volumetric and morphometric imaging in schizophrenia. Curr Top Behav Neurosci 2010; 4:243-81. [PMID: 21312403 DOI: 10.1007/7854_2010_53] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Brain imaging studies have long supported that schizophrenia is a disorder of the brain, involving many discrete and widely spread regions. Generally, studies have shown decreases in cortical gray matter (GM) volume. Here, we selectively review recent papers studying GM volume changes in schizophrenia subjects, both first-episode (FE) and chronic, in an attempt to quantify and better understand differences between healthy and patient groups. We focused on the cortical GM of the prefrontal cortex, limbic and paralimbic structures, temporal lobe, and one subcortical structure (the caudate nucleus). We performed a search of the electronic journal database PsycINFO using the keywords "schizophrenia" and "MRI," and selected for papers published between 2001 and 2008. We then screened for only those studies utilizing manual or manually edited tracing methodologies for determining regions of interest (ROIs). Each region of interest was indexed independently; thus, one paper might yield results for numerous brain regions. Our review found that in almost all ROIs, cortical GM volume was decreased in the patient populations. The only exception was the caudate nucleus - most studies reviewed showed no change, while one study showed an increase in volume; this region, however, is particularly sensitive to medication effects. The reductions were seen in both FE and chronic schizophrenia. These results clearly support that schizophrenia is an anatomical disorder of the brain, and specifically that schizophrenia patients tend to have decreased cortical GM in regions involved in higher cognition and emotional processing. That these reductions were found in both FE and chronic subjects supports that brain abnormalities are present at the onset of illness, and are not simply a consequence of chronicity. Additional studies assessing morphometry at different phases of the illness, including prodromal stages, together with longitudinal studies will elucidate further the role of progression in this disorder.
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Affiliation(s)
- James J Levitt
- Department of Psychiatry, VA Boston Healthcare System, Harvard Medical School, Brockton Campus, 116A4, 940 Belmont Street, Brockton, MA 02301, USA.
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14
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15
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Schubert MI, Porkess MV, Dashdorj N, Fone KCF, Auer DP. Effects of social isolation rearing on the limbic brain: a combined behavioral and magnetic resonance imaging volumetry study in rats. Neuroscience 2008; 159:21-30. [PMID: 19141315 DOI: 10.1016/j.neuroscience.2008.12.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Revised: 12/08/2008] [Accepted: 12/12/2008] [Indexed: 01/26/2023]
Abstract
Rearing rats in social isolation from weaning induces robust behavioral and neurobiological alterations resembling some of the core symptoms of schizophrenia, such as reduction in prepulse inhibition of acoustic startle (PPI) and locomotor hyperactivity in a novel arena. The aim of this study was to investigate whether social isolation rearing induces volumetric remodeling of the limbic system, and to probe for anatomical structure-behavioral interrelations. Isolation- (n=8) and group-reared (n=8) rats were examined by magnetic resonance (MR) volumetry using high-resolution T2-weighted imaging at 7 T. Volumes of medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), retrosplenial cortex (RSC) and hippocampal formation were compared between groups and with behavioral measures, i.e. PPI and locomotor activity in a novel arena. Isolation rearing induced locomotor hyperactivity and impaired PPI compared with group-housed rats. The right mPFC was significantly reduced (5.4%) in isolation-reared compared with group-reared rats, with a similar trend on the left side (5.2%). mPFC volumes changes were unrelated to behavioral abnormalities. No significant volume changes were observed in ACC, RSC or hippocampal formation. Hippocampal volumes were associated with the magnitude of PPI response in control but not in isolation-reared rats. Rearing rats in social isolation induced remodeling of the limbic brain with selective prefrontal cortex volume loss. In addition, a dissociation of the interrelation between hippocampal volume and PPI was noted in the isolation-reared rats. Taken together, limbic morphometry is sensitive to the effects of social isolation rearing but did not reveal direct brain-behavior interrelations, calling for more detailed circuitry analysis.
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Affiliation(s)
- M I Schubert
- Division of Academic Radiology, School of Clinical Sciences, University of Nottingham, Queen's Medical Centre, West Block, B Floor, Nottingham NG7 2UH, UK.
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16
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Molina V, Reig S, Sanz J, Palomo T, Benito C, Sarramea F, Pascau J, Sánchez J, Martín-Loeches M, Muñoz F, Desco M. Differential clinical, structural and P300 parameters in schizophrenia patients resistant to conventional neuroleptics. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:257-66. [PMID: 17900778 DOI: 10.1016/j.pnpbp.2007.08.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2006] [Revised: 07/13/2007] [Accepted: 08/11/2007] [Indexed: 10/22/2022]
Abstract
Schizophrenia is a heterogeneous clinical condition that may reflect a variety of biological processes. In particular, treatment-resistant (TR) schizophrenia may have a distinct neurobiological substrate. Within the context of clinical data, a simultaneous study with different imaging techniques could help to elucidate differences in cerebral substrates among schizophrenia patients with different responses to treatment. In the present work we used a set of biological data (basal and longitudinal volumetry, and P300 event-related potential measurements) to compare TR and treatment-responsive chronic schizophrenia patients with healthy controls. The TR patients showed higher baseline clinical scores, a more severe basal profile of brain alterations, as well as a different outcome as regards to volume deficits. These data support the notion that biological substrates vary among groups of different psychotic patients, even when they have the same diagnosis, and that those substrates may be related to the response to treatment.
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Affiliation(s)
- V Molina
- Department of Psychiatry, Hospital Clínico Universitario, Salamanca, Spain.
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17
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Rametti G, Segarra N, Junqué C, Bargalló N, Caldú X, Ibarretxe N, Bernardo M. Left posterior hippocampal density reduction using VBM and stereological MRI procedures in schizophrenia. Schizophr Res 2007; 96:62-71. [PMID: 17604968 DOI: 10.1016/j.schres.2007.04.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 04/27/2007] [Accepted: 04/29/2007] [Indexed: 11/15/2022]
Abstract
Structural deficits in the hippocampus have been implicated in the pathophysiology of schizophrenia. However the role played by structural impairments in the hippocampus in the memory deficits of schizophrenic patients remains unclear. Magnetic resonance imaging was used in this study to investigate left, right, anterior and posterior hippocampal volume and density in 28 schizophrenic patients and 33 normal controls. Voxel-based morphometry analysis showed that schizophrenics had significantly lower density in the right and posterior hippocampus than controls. MRI stereological analysis revealed significant differences in left posterior hippocampus than controls. MRI stereological analysis revealed significant differences in anterior and posterior on both sides, with the left posterior region predominating. Schizophrenics showed significant impairments in verbal learning and long term retention (P<0.001). The correlation analyses between hippocampal density and memory variables yielded a significant correlation between forgetting and density of the anterior hippocampus. These findings support the hypothesis of a regional atrophy within the hippocampus in schizophrenic patients.
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Affiliation(s)
- Giuseppina Rametti
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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18
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Vita A, De Peri L. The effects of antipsychotic treatment on cerebral structure and function in schizophrenia. Int Rev Psychiatry 2007; 19:429-36. [PMID: 17671875 DOI: 10.1080/09540260701486332] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This paper analyses the effects of antipsychotic drug treatment on cerebral structure and function in schizophrenia reviewing qualitatively some of the relevant literature on the issue. Magnetic resonance imaging (MRI) studies of brain morphology in patients at different stages of illness and after varying times of neuroleptic exposure and longitudinal studies show possible different effects of first and second generation antipsychotics. This is true also for functional parameters, such as regional cerebral blood flow and metabolism, analysed, both in resting condition and after specific activation paradigms, with such diverse techniques as positron emission tomography (PET), single photon emission computed tomography (SPECT), functional MRI and MR spectroscopy. The possible molecular mechanisms underlying such differences and whether they represent direct drug effects or indirect consequences of their different and specific interactions with the 'natural' pathophysiological trajectory of brain abnormalities in schizophrenia are matter of present research and debate.
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Affiliation(s)
- Antonio Vita
- Psychiatric Unit, Department of Mental Health, Spedali Civili, University of Brescia, Italy.
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19
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Steen RG, Mull C, McClure R, Hamer RM, Lieberman JA. Brain volume in first-episode schizophrenia: systematic review and meta-analysis of magnetic resonance imaging studies. Br J Psychiatry 2006; 188:510-8. [PMID: 16738340 DOI: 10.1192/bjp.188.6.510] [Citation(s) in RCA: 544] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Studies of people with schizophrenia assessed using magnetic resonance imaging (MRI) usually include patients with first-episode and chronic disease, yet brain abnormalities may be limited to those with chronic schizophrenia. AIMS To determine whether patients with a first episode of schizophrenia have characteristic brain abnormalities. METHOD Systematic review and meta-analysis of 66 papers comparing brain volume in patients with a first psychotic episode with volume in healthy controls. RESULTS A total of 52 cross-sectional studies included 1424 patients with a first psychotic episode; 16 longitudinal studies included 465 such patients. Meta-analysis suggests that whole brain and hippocampal volume are reduced (both P<0.0001) and that ventricular volume is increased (P<0.0001) in these patients relative to healthy controls. CONCLUSIONS Average volumetric changes are close to the limit of detection by MRI methods. It remains to be determined whether schizophrenia is a neurodegenerative process that begins at about the time of symptom onset, or whether it is better characterised as a neurodevelopmental process that produces abnormal brain volumes at an early age.
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Affiliation(s)
- R Grant Steen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box 7160, Chapel Hill, North Carolina 27599-7160, USA.
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20
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Tanskanen P, Veijola JM, Piippo UK, Haapea M, Miettunen JA, Pyhtinen J, Bullmore ET, Jones PB, Isohanni MK. Hippocampus and amygdala volumes in schizophrenia and other psychoses in the Northern Finland 1966 birth cohort. Schizophr Res 2005; 75:283-94. [PMID: 15885519 DOI: 10.1016/j.schres.2004.09.022] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2004] [Revised: 09/13/2004] [Accepted: 09/20/2004] [Indexed: 11/19/2022]
Abstract
Structural brain differences have been reported in many studies with schizophrenia, but few have involved a general population birth cohort. We investigated differences in volume, shape and laterality of hippocampus and amygdala in patients with schizophrenia, all psychoses and comparison subjects within a large general birth cohort sample, and explored effects of family history of psychosis, perinatal risk and age-at-onset of illness. All subjects with psychosis from the Northern Finland 1966 birth cohort were invited to a survey including MRI scan of the brain, conducted in 1999-2001. Comparison subjects not known to have psychosis were randomly selected from the same cohort. Volumes of hippocampus and amygdala were measured in 56 subjects with DSM-III-R schizophrenia, 26 patients with other psychoses and 104 comparison subjects. Small hippocampal volume reductions in schizophrenia (2%) and all psychoses (3%) were not significant when adjusted for total brain volume. The shape of hippocampus in schizophrenia did not differ significantly from comparison subjects. Right hippocampus and amygdala were significantly larger than the left in all groups. Mean amygdala volume in schizophrenia or all psychoses did not differ from comparison subjects. Patients with family history of psychosis had larger hippocampus than patients without. Neither perinatal risk nor age-at-onset of illness had any effect on hippocampal or amygdala volumes. Small hippocampal volume reduction in schizophrenia and all psychoses was not disproportionate to reduced whole brain volume in this population-based sample. Perinatal events that have been suggested as of etiological importance in structural pathology of psychosis had no effect.
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Affiliation(s)
- Päivikki Tanskanen
- University of Oulu, Department of Radiology, P.O. Box 50, FIN-90029 Oys, Finland.
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21
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Geuze E, Vermetten E, Bremner JD. MR-based in vivo hippocampal volumetrics: 2. Findings in neuropsychiatric disorders. Mol Psychiatry 2005; 10:160-84. [PMID: 15356639 DOI: 10.1038/sj.mp.4001579] [Citation(s) in RCA: 272] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Magnetic resonance imaging (MRI) has opened a new window to the brain. Measuring hippocampal volume with MRI has provided important information about several neuropsychiatric disorders. We reviewed the literature and selected all English-language, human subject, data-driven papers on hippocampal volumetry, yielding a database of 423 records. Smaller hippocampal volumes have been reported in epilepsy, Alzheimer's disease, dementia, mild cognitive impairment, the aged, traumatic brain injury, cardiac arrest, Parkinson's disease, Huntington's disease, Cushing's disease, herpes simplex encephalitis, Turner's syndrome, Down's syndrome, survivors of low birth weight, schizophrenia, major depression, posttraumatic stress disorder, chronic alcoholism, borderline personality disorder, obsessive-compulsive disorder, and antisocial personality disorder. Significantly larger hippocampal volumes have been correlated with autism and children with fragile X syndrome. Preservation of hippocampal volume has been reported in congenital hyperplasia, children with fetal alcohol syndrome, anorexia nervosa, attention-deficit and hyperactivity disorder, bipolar disorder, and panic disorder. Possible mechanisms of hippocampal volume loss in neuropsychiatric disorders are discussed.
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Affiliation(s)
- E Geuze
- Department of Military Psychiatry, Central Military Hospital, Utrecht, Rudolf Magnus Institute of Neuroscience, Mailbox B.01.2.06, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
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22
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Weiss AP, Dewitt I, Goff D, Ditman T, Heckers S. Anterior and posterior hippocampal volumes in schizophrenia. Schizophr Res 2005; 73:103-12. [PMID: 15567082 DOI: 10.1016/j.schres.2004.05.018] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2004] [Revised: 05/21/2004] [Accepted: 05/28/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND While the evidence for hippocampal structural abnormalities in schizophrenia is now well accepted, whether there is differentially greater volume loss within specific subregions of the hippocampus remains a matter of some debate. Here we present volume estimates of anterior and posterior hippocampal volumes using a novel morphometric protocol. METHODS We studied 25 male patients with schizophrenia and 25 age-matched male control subjects. Hippocampal volumes were estimated using a three-dimensional morphometric protocol for the analysis of high-resolution structural magnetic resonance images (MRI). Anterior hippocampal volumes were differentiated from posterior hippocampal volumes by the presence of the uncus in coronal slices. RESULTS While the patients with schizophrenia had significantly smaller overall hippocampal volumes relative to the control group, there was no evidence for a topographically specific pattern of volume loss along the anterior-posterior hippocampal axis. CONCLUSIONS These results confirm the presence of overall hippocampal volume decreases in patients with schizophrenia, but do not confirm a topographically specific localization of this effect. It appears that the hippocampal volume deficit in schizophrenia is diffuse, a finding that has important consequences for understanding the underlying pathophysiologic mechanisms in schizophrenia.
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Affiliation(s)
- Anthony P Weiss
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
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23
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Kiefer C, Slotboom J, Buri C, Gralla J, Remonda L, Dierks T, Strik WK, Schroth G, Kalus P. Differentiating hippocampal subregions by means of quantitative magnetization transfer and relaxometry: preliminary results. Neuroimage 2005; 23:1093-9. [PMID: 15528109 DOI: 10.1016/j.neuroimage.2004.07.066] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2004] [Revised: 06/05/2004] [Accepted: 07/29/2004] [Indexed: 11/23/2022] Open
Abstract
The hippocampal formation (HF) of healthy control subjects and schizophrenic patients was examined using an MRI experiment that implements sequences for relaxometry and magnetization transfer (MT) quantification. In addition to the semi-quantitative magnetization transfer ratio (MTR), all of the observable properties of the binary spin bath model were included. The study demonstrates that, in contrast to the MTR, quantitative MT parameters (especially the T2 relaxation time of restricted protons, T2b) are capable to differentiate functionally significant subregions within the HF. The MT methodology appears to be a promising new tool for the differential microstructural evaluation of the HF in neuropsychiatric disorders accompanied by memory disturbances.
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Affiliation(s)
- Claus Kiefer
- Institute for Diagnostic and Interventional Neuroradiology, University Hospital Bern (Inselspital), Freiburgstrasse 4, CH-3010 Bern, Switzerland.
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24
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Scherk H, Falkai P. Ver�nderungen der Hirnstruktur durch neuroleptische Medikation. DER NERVENARZT 2004; 75:1112-7. [PMID: 15365632 DOI: 10.1007/s00115-004-1793-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A couple of studies showed that neuroleptic treatment affects brain morphology. This paper reviews findings of volumetric longitudinal studies on treated schizophrenics, longitudinal studies considering the effect of different neuroleptic treatments on brain morphology, and studies on neuroleptic-naive patients with schizophrenia. The latter studies show enlargement of ventricles, diminished volume of the thalamus and reduced gray matter in different cortical regions. Findings on the nucleus caudatus, hippocampus, and amygdala are inconsistent. The volumes of the putamen and globus pallidus are unchanged. Medication with typical antipsychotics leads to increased volume of the nucleus caudatus while atypical antipsychotics do not change the volume of the nucleus caudatus.
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Affiliation(s)
- H Scherk
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum des Saarlandes, Homburg/Saar.
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25
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Lee JM, Kim SH, Jang DP, Ha TH, Kim JJ, Kim IY, Kwon JS, Kim SI. Deformable model with surface registration for hippocampal shape deformity analysis in schizophrenia. Neuroimage 2004; 22:831-40. [PMID: 15193612 DOI: 10.1016/j.neuroimage.2004.02.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2003] [Revised: 02/04/2004] [Accepted: 02/05/2004] [Indexed: 11/21/2022] Open
Abstract
Changes to the hippocampal structure have been reported as consistent structural abnormalities in schizophrenic patients and have been related to the learning and memory deficits in such patients. Although many magnetic resonance (MR) imaging studies have focused on the hippocampal volume, local structural changes were difficult to discriminate from normal neuroanatomical variations. 3D shape deformation analysis of the brain structure may reflect localized schizophrenic abnormalities. A deformable model, evolved from the ellipsoid to hippocampal surface, with 2562 vertexes, was developed to analyze the left and right hippocampus shapes in 22 schizophrenic patients and 22 healthy age and gender matched controls. One of the most critical issues in the shape analysis is the determination of homologous points between two objects. To determine more accurate corresponding points, an alignment procedure, consisting of coarse and fine steps, following a deformation process, was applied. The performance of the alignment process was tested using artificial data, to get the alignment error to within 3 degrees for each angle. A volume analysis indicated the hippocampal volume to be bilaterally reduced in schizophrenic patients compared to the normal controls, with a shape analysis showing a deformity pattern of the hippocampal surface. Bilateral inward deformities in the anterior and posterior hippocampus and a unilateral outward deformity in the right anterior hippocampus were observed, respectively.
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Affiliation(s)
- Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, South Korea
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26
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Kalus P, Buri C, Slotboom J, Gralla J, Remonda L, Dierks T, Strik WK, Schroth G, Kiefer C. Volumetry and diffusion tensor imaging of hippocampal subregions in schizophrenia. Neuroreport 2004; 15:867-71. [PMID: 15073533 DOI: 10.1097/00001756-200404090-00027] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Previous MRI-volumetric studies in schizophrenic psychoses have demonstrated more or less pronounced volume reductions of the hippocampus in patients. Correspondingly, neuropathological examinations on the brains of schizophrenics showed diverse structural changes of the hippocampus. Employing a high-resolution 3D-MPRAGE sequence, we found volume reductions in most hippocampal subregions of schizophrenic patients, which, however, did not reach significant levels. An analysis of co-registered diffusion tensor imaging (DTI) data revealed significant alterations of the inter-voxel coherences in single hippocampal subdivisions of these patients, supporting the assumption of characteristic microstructural tissue changes relevant for the pathogenesis of schizophrenic psychoses. Our results argue for the usage of additional MRI modalities like DTI in order to detect subtle regional alterations of hippocampal structure in schizophrenics.
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Affiliation(s)
- Peter Kalus
- Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
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27
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Joyal CC, Laakso MP, Tiihonen J, Syvälahti E, Vilkman H, Laakso A, Alakare B, Räkköläinen V, Salokangas RKR, Hietala J. The amygdala and schizophrenia: a volumetric magnetic resonance imaging study in first-episode, neuroleptic-naive patients. Biol Psychiatry 2003; 54:1302-4. [PMID: 14643099 DOI: 10.1016/s0006-3223(03)00597-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The attempts to evaluate amygdaloid volumes using magnetic resonance imaging (MRI) in patients with schizophrenia have yielded highly divergent results. METHODS Volumes of the amygdala were measured in 22 healthy participants and 18 neuroleptic-naive patients with first-episode schizophrenia, while controlling for intracranial area, gender, age, and handedness. RESULTS Persons with schizophrenia presented significantly lower amygdaloid volumes bilaterally. No significant correlations were found between the amygdaloid volumes and either the duration of the disease or the symptom severity. CONCLUSIONS Amygdaloid volume anomalies are already present in the early phases of schizophrenia.
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28
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Phillips ML, Drevets WC, Rauch SL, Lane R. Neurobiology of emotion perception II: Implications for major psychiatric disorders. Biol Psychiatry 2003; 54:515-28. [PMID: 12946880 DOI: 10.1016/s0006-3223(03)00171-9] [Citation(s) in RCA: 1221] [Impact Index Per Article: 58.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
To date, there has been little investigation of the neurobiological basis of emotion processing abnormalities in psychiatric populations. We have previously discussed two neural systems: 1) a ventral system, including the amygdala, insula, ventral striatum, ventral anterior cingulate gyrus, and prefrontal cortex, for identification of the emotional significance of a stimulus, production of affective states, and automatic regulation of emotional responses; and 2) a dorsal system, including the hippocampus, dorsal anterior cingulate gyrus, and prefrontal cortex, for the effortful regulation of affective states and subsequent behavior. In this critical review, we have examined evidence from studies employing a variety of techniques for distinct patterns of structural and functional abnormalities in these neural systems in schizophrenia, bipolar disorder, and major depressive disorder. In each psychiatric disorder, the pattern of abnormalities may be associated with specific symptoms, including emotional flattening, anhedonia, and persecutory delusions in schizophrenia, prominent mood swings, emotional lability, and distractibility in bipolar disorder during depression and mania, and with depressed mood and anhedonia in major depressive disorder. We suggest that distinct patterns of structural and functional abnormalities in neural systems important for emotion processing are associated with specific symptoms of schizophrenia and bipolar and major depressive disorder.
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Affiliation(s)
- Mary L Phillips
- Division of Psychological Medicine, Institute of Psychiatry, London, United Kingdom
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29
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Pegues MP, Rogers LJ, Amend D, Vinogradov S, Deicken RF. Anterior hippocampal volume reduction in male patients with schizophrenia. Schizophr Res 2003; 60:105-15. [PMID: 12591575 DOI: 10.1016/s0920-9964(02)00288-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Quantitative high resolution magnetic resonance imaging (MRI) was utilized to measure anterior, posterior, and total hippocampal volumes in 27 male patients with chronic schizophrenia and 24 male controls. To optimize measurement techniques, hippocampal volumes were: (1) acquired with 1.4-mm slices; (2) excluded with the amygdala; (3) normalized for position; and (4) corrected for total intracranial volume (ICV). The results of a linear mixed effects regression analysis, which made it possible to analyze total anterior and total posterior hippocampal volumes separately, indicated that the anterior hippocampus was significantly smaller in the schizophrenic group relative to the control group. There were no significant group differences with respect to posterior hippocampal volumes, and no significant correlations between hippocampal volumes and illness duration. A significant lateralized asymmetry was also noted in both groups with the right hippocampal volume being larger than the left. These preliminary findings support a significant anterior hippocampal volume reduction in men with schizophrenia as well as a similar hippocampal volume asymmetry in both male controls and schizophrenics.
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Affiliation(s)
- Mary P Pegues
- Psychiatry Service, Department of Veterans Affairs Medical Center, 94121, San Francisco, CA, USA
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30
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Joyal CC, Laakso MP, Tiihonen J, Syvälahti E, Vilkman H, Laakso A, Alakare B, Räkköläinen V, Salokangas RKR, Hietala J. A volumetric MRI study of the entorhinal cortex in first episode neuroleptic-naive schizophrenia. Biol Psychiatry 2002; 51:1005-7. [PMID: 12062885 DOI: 10.1016/s0006-3223(01)01368-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Imaging studies have frequently reported volume loss of limbic structures in schizophrenia, yet there appears to be no quantitative data on entorhinal cortex volumes in patients with neuroleptic naive first-episode schizophrenia. METHODS The volume of the entorhinal cortices of 22 control subjects and 18 patients with neuroleptic-naïve first-episode schizophrenia were measured from magnetic resonance images (MRI) scans using recently designed anatomic criteria for MRI anatomy of the entorhinal cortex. RESULTS Smaller entorhinal volumes were found bilaterally in the schizophrenic patients. This volume loss did not correlate with items on the Positive and Negative Syndrome Scale. CONCLUSIONS These data suggest early involvement of the entorhinal cortex in schizophrenia.
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31
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Rajarethinam R, DeQuardo JR, Miedler J, Arndt S, Kirbat R, Brunberg JA, Tandon R. Hippocampus and amygdala in schizophrenia: assessment of the relationship of neuroanatomy to psychopathology. Psychiatry Res 2001; 108:79-87. [PMID: 11738542 DOI: 10.1016/s0925-4927(01)00120-2] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The hippocampus and amygdala are believed to be involved in the pathology of schizophrenia. In this study, we attempted to replicate the reported bilateral volume reduction of the hippocampus and amygdala and to study the relationship of the volumes of these structures to the symptoms of schizophrenia. The hippocampus-amygdala complex (HAC) was manually traced on 3-mm coronal T(1)-weighted MRIs, resampled into 1-mm coronal slices, from 20 male patients with schizophrenia and 20 age-matched male controls. The complex was divided into three parts: anterior one-third representing the amygdala and middle and posterior thirds representing the anterior and posterior halves of the hippocampus. Positive and negative symptoms and severity of hallucinations and thought disorder (conceptual disorganization) were quantified using the Brief Psychiatric Rating Scale (BPRS). None of the above structures, controlled for brain volume, differed significantly in patients compared with normal controls. When the relationship between volumes and symptoms was examined, the left HAC was found to inversely correlate with thought disorder and negative symptoms. Specifically, significant inverse correlations were found between (i) left amygdala and thought disorder, (ii) left hippocampus and negative symptoms, and (iii) left anterior and posterior hippocampus volumes and positive and negative symptoms, respectively. Our findings further support the role of the HAC in the pathophysiology of schizophrenia and suggest unique associations between individual structures and specific symptoms of the illness.
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Affiliation(s)
- R Rajarethinam
- Department of Psychiatry, PBMP, Wayne State University, 2751 E. Jefferson, Suite 200, Room 265, Detroit, MI 48207, USA.
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