1
|
Fortea A, Pinzón-Espinosa J, Ilzarbe D, Espinosa L, Lázaro L, Calvo RM, Castro-Fornieles J, de la Serna E, Bargalló N, Baeza I, Sugranyes G. Radiological findings in brain MRI scans in youth with early-onset psychosis: A controlled study. J Psychiatr Res 2022; 156:151-158. [PMID: 36252344 DOI: 10.1016/j.jpsychires.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/08/2022] [Accepted: 10/03/2022] [Indexed: 12/12/2022]
Abstract
There is a lack of consensus on whether routine brain magnetic resonance imaging (MRI) should be recommended as part of the initial assessment in patients with psychosis. No study so far has qualitatively assessed brain MRI in patients with early-onset psychosis (EOP), in whom neurodevelopmental factors may play a stronger role. We aimed to determine the prevalence of brain MRI findings in patients with EOP compared to healthy controls, and assess whether these findings were clinically relevant. Retrospective clinical chart review of all patients with EOP in whom a brain MRI scan was acquired during admission to an inpatient child and adolescent psychiatry unit during January 2013-December 2017, compared to age and biologically assigned gender matched healthy controls. Between group analyses tested differences in rates of qualitatively abnormal MRI scans and changes in clinical management as a result of radiological findings. A total of 256 individuals were included (128 patients with EOP and 128 healthy controls). Patients with EOP presented with a significantly higher rate of abnormal MRI scans relative to healthy controls (21.9% vs 11.7%, p = .030; OR = 2.11, [95% CI:1.06-4.17]). Radiological findings in the EOP group triggered clinical referral for further evaluation or management more often than in the healthy control group (7.0% vs 1.6%, p = .030; OR = 4.76, [95% CI:1.01-22.50]). MRI scans in youth with EOP may be characterized by an increased number of radiological abnormalities than in controls. The rates of MRI findings requiring clinical referral suggests that routine MRI acquisition may need to be considered in patients with EOP.
Collapse
Affiliation(s)
- Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; Fundació Clínic per a La Recerca Biomèdica (FCRB), 153 Rosselló St., Barcelona, 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Justo Pinzón-Espinosa
- Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Mental Health, Parc Tauli University Hospital, Sabadell, 1 Parc Taulí, Sabadell, 08208, Barcelona, Spain; Department of Clinical Psychiatry, School of Medicine, University of Panama, Ave. Octavio Méndez Pereira, Panamá, XFJ8+V2Q, Panama
| | - Daniel Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Laura Espinosa
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Child and Adolescent Psychiatry, Hospital Sant Joan de Deu, Fundació Althaia, 1-3 Dr. Joan Soler St., Manresa, 08243, Barcelona, Spain
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Rosa M Calvo
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Nuria Bargalló
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Department of Radiology, Imaging Diagnosis Center, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Fundació Clínic per a La Recerca Biomèdica (FCRB), 153 Rosselló St., Barcelona, 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain.
| |
Collapse
|
2
|
Despotovski V, Vivekanandarajah A, Waters KA, Machaalani R. Expression of reelin with age in the human hippocampal formation. Hippocampus 2021; 31:493-502. [PMID: 33539623 DOI: 10.1002/hipo.23310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/30/2020] [Accepted: 01/23/2021] [Indexed: 12/23/2022]
Abstract
Reelin plays a key role in neuronal migration and lamination in the cortex and hippocampus. Animal studies have shown that reelin expression decreases with age. The aim of this study was to evaluate the expression of reelin in all layers of the human hippocampal formation across three age groups. We used immunohistochemistry in formalin fixed and paraffin embedded hippocampal tissue from infants (1-10 months; n = 9), children (4-10 years; n = 4), and adults (45-60 years; n = 6) to stain for reelin. Expression was quantified (measured as the number of positive reelin cells/mm2 ) in the granule cell layer of the dentate gyrus (DG), the molecular layer of the dentate gyrus (ML), the hippocampal fissure (HF), stratum lacunosum moleculare (SLM), CA4/Hilus and the stratum pyramidale layer of CA3, CA2, and CA1. Expression of reelin was highest in the HF irrespective of age, followed by the SLM and ML. Minimal to no expression was seen in the stratum pyramidale layer of CA1-3. With age, reelin expression decreased and was statistically significant from infancy to childhood in the HF (p = .02). This study confirms that reelin expression decreases with age in the human hippocampus, and shows for the first time that the major decrease occurs between infancy and early childhood.
Collapse
Affiliation(s)
- Vanessa Despotovski
- Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Arunnjah Vivekanandarajah
- Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen A Waters
- Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rita Machaalani
- Discipline of Medicine, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Discipline of Child and Adolescent Health, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
3
|
Vivekananda U, Cock H, Mula M. A case of de novo psychosis ten years following successful epilepsy surgery. Seizure 2016; 41:4-5. [DOI: 10.1016/j.seizure.2016.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 10/21/2022] Open
|
4
|
Martinoni M, Berti PP, Marucci G, Rubboli G, Volpi L, Riguzzi P, Marliani F, Toni F, Bisulli F, Tinuper P, Michelucci R, Baruzzi A, Giulioni M. Pathology-Based Approach to Seizure Outcome After Surgery for Pharmacoresistant Medial Temporal Lobe Epilepsy. World Neurosurg 2016; 90:448-453. [PMID: 26968448 DOI: 10.1016/j.wneu.2016.02.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hippocampal sclerosis (HS) is the most common cause of drug-resistant medial temporal lobe epilepsy (MTLE). Structural abnormalities such as HS, granule cell pathology (GCP), and focal cortical dysplasia (FCD) have been classified histopathologically, possibly allowing a more accurate assessment of prognostic seizure and neuropsychologic outcomes. We correlated seizure outcome with comprehensive temporal lobe pathologic findings, identified according to the most recent classification systems of HS, GCP, and FCD. METHODS All the 83 patients who underwent anterior temporal lobectomy (ATL) for drug-resistant MTLE and with a proven diagnosis of HS between April 2001 and May 2014 were collected. Patients were divided in 2 main groups: 1) isolated HS with/without GCP (HS +/- GCP); and 2) HS associated with FCD with/without GCP (HS+FCD +/- GCP). Patients were followed up at least 1 year, and seizure outcome was reported in accordance with Engel classification. RESULTS Group I: HS +/- GCP: Statistical analysis confirmed a better outcome in HS + GCP patients than in HS-no GCP (P < 0.05). Moreover, a better outcome for the patients affected by GCP type I was observed (P < 0.05). Group II: HS+FCD +/- GCP: Patients with HS variant type I presented a better seizure outcome than the patients with HS type II (Engel class IA HS type I vs. type II: 69% vs. 40%). CONCLUSIONS A pathology-based approach to epilepsy surgery might improve the interpretation of the results, could predict which cases will enjoy a better seizure outcome, and could help to the comprehension of the causes of failures.
Collapse
Affiliation(s)
- Matteo Martinoni
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy.
| | - Pier Paolo Berti
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - Gianluca Marucci
- Section of Pathology, "M. Malpighi," Bellaria Hospital, Azienda USL-IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Guido Rubboli
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Danish Epilepsy Centre, Dianalund, Denmark
| | - Lilia Volpi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Patrizia Riguzzi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Federica Marliani
- IRCCS Institute of Neurological Science of Bologna, Division of Neuroradiology, Bellaria Hospital, Bologna, Italy
| | - Francesco Toni
- IRCCS Institute of Neurological Science of Bologna, Division of Neuroradiology, Bellaria Hospital, Bologna, Italy
| | - Francesca Bisulli
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Paolo Tinuper
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Roberto Michelucci
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy
| | - Agostino Baruzzi
- IRCCS Institute of Neurological Science of Bologna, Division of Neurology, Bellaria Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Giulioni
- IRCCS Institute of Neurological Science of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy
| |
Collapse
|
5
|
Giulioni M, Martinoni M, Marucci G. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain 2016; 139:e35. [PMID: 26966137 DOI: 10.1093/brain/aww040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Marco Giulioni
- IRCCS Institute of Neurological Sciences of Bologna, Section of Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - Matteo Martinoni
- IRCCS Institute of Neurological Sciences of Bologna, Section of Neurosurgery, Bellaria Hospital, Bologna, Italy
| | - Gianluca Marucci
- Section of Pathology "M. Malpighi", Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy
| |
Collapse
|
6
|
Kandratavicius L, Peixoto-Santos JE, Monteiro MR, Scandiuzzi RC, Carlotti CG, Assirati JA, Hallak JE, Leite JP. Mesial temporal lobe epilepsy with psychiatric comorbidities: a place for differential neuroinflammatory interplay. J Neuroinflammation 2015; 12:38. [PMID: 25889039 PMCID: PMC4347571 DOI: 10.1186/s12974-015-0266-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 02/10/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Despite the strong association between epilepsy and psychiatric comorbidities, few biological substrates are currently described. We have previously reported neuropathological alterations in mesial temporal lobe epilepsy (MTLE) patients with major depression and psychosis that suggest a morphological and neurochemical basis for psychopathological symptoms. Neuroinflammatory-related structures and molecules might be part of the altered neurochemical milieu underlying the association between epilepsy and psychiatric comorbidities, and such features have not been previously investigated in humans. METHODS MTLE hippocampi of subjects without psychiatric history (MTLEW), MTLE + major depression (MTLE + D), and MTLE + interictal psychosis (MTLE + P) derived from epilepsy surgery and control necropsies were investigated for reactive astrocytes (glial fibrillary acidic protein (GFAP)), activated microglia (human leukocyte antigen, MHC class II (HLA-DR)), glial metallothionein-I/II (MT-I/II), and aquaporin 4 (AQP4) immunohistochemistry. RESULTS We found an increased GFAP immunoreactive area in the molecular layers, granule cell layer, and cornus ammonis region 2 (CA2) and cornus ammonis region 1 (CA1) of MTLEW and MTLE + P, respectively, compared to MTLE + D. HLA-DR immunoreactive area was higher in cornus ammonis region 3 (CA3) of MTLE + P, compared to MTLE + D and MTLEW, and in the hilus, when compared to MTLEW. MTLEW cases showed increased MT-I/II area in the granule cell layer and CA1, compared to MTLE + P, and in the parasubiculum, when compared to MTLE + D and MTLE + P. Differences between MTLE and control, such as astrogliosis, microgliosis, increased MT-I/II, and decreased perivascular AQP4 in the epileptogenic hippocampus, were in agreement to what is currently described in the literature. CONCLUSIONS Neuroinflammatory-related molecules in MTLE hippocampus show a distinct pattern of expression when patients present with a comorbid psychiatric diagnosis, similar to what is found in the pure forms of schizophrenia and major depression. Future studies focusing on inflammatory characteristics of MTLE with psychiatric comorbidities might help in the design of better therapeutic strategies.
Collapse
Affiliation(s)
- Ludmyla Kandratavicius
- Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of Sao Paulo (USP), Av Bandeirantes 3900, CEP 14049-900, Ribeirao Preto, SP, Brazil. .,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Ribeirao Preto, Brazil.
| | - Jose Eduardo Peixoto-Santos
- Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of Sao Paulo (USP), Av Bandeirantes 3900, CEP 14049-900, Ribeirao Preto, SP, Brazil.
| | - Mariana Raquel Monteiro
- Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of Sao Paulo (USP), Av Bandeirantes 3900, CEP 14049-900, Ribeirao Preto, SP, Brazil.
| | - Renata Caldo Scandiuzzi
- Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of Sao Paulo (USP), Av Bandeirantes 3900, CEP 14049-900, Ribeirao Preto, SP, Brazil.
| | | | | | - Jaime Eduardo Hallak
- Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of Sao Paulo (USP), Av Bandeirantes 3900, CEP 14049-900, Ribeirao Preto, SP, Brazil. .,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Ribeirao Preto, Brazil. .,National Institute of Science and Technology in Translational Medicine (INCT-TM - CNPq), Ribeirao Preto, Brazil.
| | - Joao Pereira Leite
- Department of Neurosciences and Behavior, Ribeirao Preto Medical School, University of Sao Paulo (USP), Av Bandeirantes 3900, CEP 14049-900, Ribeirao Preto, SP, Brazil. .,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Ribeirao Preto, Brazil.
| |
Collapse
|
7
|
Kandratavicius L, Hallak JE, Carlotti CG, Assirati JA, Leite JP. Neurotrophin receptors expression in mesial temporal lobe epilepsy with and without psychiatric comorbidities and their relation with seizure type and surgical outcome. Acta Neuropathol Commun 2014; 2:81. [PMID: 25027171 PMCID: PMC4149196 DOI: 10.1186/s40478-014-0081-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 06/29/2014] [Indexed: 12/30/2022] Open
Abstract
Epilepsy and psychiatric comorbidities are frequently associated, but their common biological substrate is unknown. We have previously reported altered structural elements and neurotrophins (NTs) expression in mesial temporal lobe epilepsy (MTLE) patients with psychiatric comorbidities. NTs receptors can regulate neurotransmission and promote neuroplasticity, being important candidates in the regulation and manifestation of psychopatological states and seizure-related events. MTLE hippocampi of subjects without psychiatric history, MTLE + major depression, MTLE + interictal psychosis derived from epilepsy surgery, and control necropsies were investigated for p75NTR, TrkB, TrkA, and TrkC immunohistochemistry. Increased expression of p75NTR, decreased TrkA, unaltered TrkC, and complex alterations involving TrkB expression were seen in MTLE groups. Increased TrkB expression in patients without complete seizure remission and in those with secondarily generalized seizures was seen. Decreased p75NTR expression associated with interictal psychosis, and increased TrkB in those with psychosis or major depression was also reported, although their p75NTR/TrkB ratios were lower than in MTLE without psychiatric comorbidities. Our results provide evidence of alterations in expression of NTs receptors in the epileptogenic hippocampus that are differentially modulated in presence of psychiatric comorbidities. As already explored in animal models, even in chronic human MTLE increased TrkB expression, among other NT receptors alterations, may play a major role in seizure type, frequency and surgery outcome.
Collapse
|