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de Souza Crippa JA, Zuardi AW, Busatto GF, Sanches RF, Santos AC, Araújo D, Amaro E, Hallak JEC, Ng V, McGuire PK. Cavum septum pellucidum and adhesio interthalamica in schizophrenia: an MRI study. Eur Psychiatry 2020; 21:291-9. [PMID: 16406503 DOI: 10.1016/j.eurpsy.2005.09.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Accepted: 09/13/2005] [Indexed: 11/28/2022] Open
Abstract
AbstractSeveral studies have independently suggested that patients with schizophrenia are more likely to have an enlarged cavum septum pellucidum (CSP) and an absent adhesio interthalamica (AI), respectively. However, neither finding has been consistently replicated and it is unclear whether there is an association between these two midline brain abnormalities. Thus, we compared the prevalence of absent AI and the prevalence, size and volume of CSP in 38 patients with schizophrenia and 38 healthy controls using magnetic resonance imaging (MRI). There were no between group differences in the presence or volume of CSP; however, an enlarged CSP was commoner among patients than controls. There was also a positive correlation between CSP ratings and volumes. No differences in the presence or absence of the AI were found between patients and controls; however, an absent AI was commoner in male patients with schizophrenia than females. There was absolutely no overlap between the presence of a large CSP and an absence of AI. In conclusion, our findings are in line with several case series and other MRI investigations that have shown a higher incidence of putatively developmental brain abnormalities in patients with schizophrenia, particularly in males, and support the neurodevelopmental model of this disorder.
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Affiliation(s)
- José Alexandre de Souza Crippa
- Department of Neuropsychiatry and Medical Psychology, Faculty of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Ben-Zion Z, Artzi M, Niry D, Keynan NJ, Zeevi Y, Admon R, Sharon H, Halpern P, Liberzon I, Shalev AY, Hendler T. Neuroanatomical Risk Factors for Posttraumatic Stress Disorder in Recent Trauma Survivors. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:311-319. [PMID: 31973980 PMCID: PMC7064406 DOI: 10.1016/j.bpsc.2019.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Low hippocampal volume could serve as an early risk factor for posttraumatic stress disorder (PTSD) in interaction with other brain anomalies of developmental origin. One such anomaly may well be the presence of a large cavum septum pellucidum (CSP), which has been loosely associated with PTSD. We performed a longitudinal prospective study of recent trauma survivors. We hypothesized that at 1 month after trauma exposure the relation between hippocampal volume and PTSD symptom severity will be moderated by CSP volume, and that this early interaction will account for persistent PTSD symptoms at subsequent time points. METHODS One hundred seventy-one adults (87 women, average age 34.22 years [range, 18-65 years of age]) who were admitted to a general hospital's emergency department after a traumatic event underwent clinical assessment and structural magnetic resonance imaging within 1 month after trauma. Follow-up clinical evaluations were conducted at 6 (n = 97) and 14 (n = 78) months after trauma. Hippocampal and CSP volumes were measured automatically by FreeSurfer software and verified manually by a neuroradiologist (D.N.). RESULTS At 1 month after trauma, CSP volume significantly moderated the relation between hippocampal volume and PTSD severity (p = .026), and this interaction further predicted symptom severity at 14 months posttrauma (p = .018). Specifically, individuals with a smaller hippocampus and larger CSP at 1 month posttrauma showed more severe symptoms at 1 and 14 months after trauma exposure. CONCLUSIONS Our study provides evidence for an early neuroanatomical risk factors for PTSD, which could also predict the progression of the disorder in the year after trauma exposure. Such a simple-to-acquire neuroanatomical signature for PTSD could guide early management as well as long-term monitoring.
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Affiliation(s)
- Ziv Ben-Zion
- Sagol Brain Institute Tel Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Moran Artzi
- Sagol Brain Institute Tel Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Niry
- Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nimrod Jackob Keynan
- Sagol Brain Institute Tel Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Zeevi
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - Roee Admon
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Haggai Sharon
- Sagol Brain Institute Tel Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Institute of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pain Management and Neuromodulation Centre, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom
| | - Pinchas Halpern
- Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M Health Science Center, Bryan, Texas
| | - Arieh Y Shalev
- Department of Psychiatry, New York University Langone Medical Center, New York, New York
| | - Talma Hendler
- Sagol Brain Institute Tel Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel.
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3
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Dremmen MHG, Bouhuis RH, Blanken LME, Muetzel RL, Vernooij MW, Marroun HE, Jaddoe VWV, Verhulst FC, Tiemeier H, White T. Cavum Septum Pellucidum in the General Pediatric Population and Its Relation to Surrounding Brain Structure Volumes, Cognitive Function, and Emotional or Behavioral Problems. AJNR Am J Neuroradiol 2019; 40:340-346. [PMID: 30679220 DOI: 10.3174/ajnr.a5939] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/01/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The cavum septum pellucidum, a cavity filled with CSF, is localized between the 2 lateral ventricles of the brain. The cavum is present in all neonates, but it typically closes within 5 months after birth. In some cases, this closure does not occur and a persistent or enlarged cavum septum pellucidum has been linked, in some studies, to psychiatric disorders. However, the clinical relevance in the general population is unknown. In this study, we examined the relationship between the cavum septum pellucidum and volumes of brain structures, cognitive function, and emotional and behavioral problems in children. MATERIALS AND METHODS This study was embedded in the Generation R Study, a prospective cohort in Rotterdam, the Netherlands. MR imaging studies of 1070 children, 6-10 years of age, were systematically evaluated for the presence and length of a persistent cavum septum pellucidum. An enlarged cavum septum pellucidum was defined as a cavum length of ≥6 mm. Groups without, with persistent, and with enlarged cavum septi pellucidi were compared for brain structure volumes, nonverbal intelligence, and emotional and behavioral problems. RESULTS The prevalence of cavum septi pellucidi in our sample was 4.6%. Children with an enlarged cavum septum pellucidum had a larger corpus callosum, greater thalamic and total white matter-to-total brain volume ratio, and smaller lateral ventricle volumes. We did not find a relationship between cavum septi pellucidi and cognitive function or emotional and behavioral problems. CONCLUSIONS The cavum septum pellucidum is a normal structural brain variation without clinical implications in this population-based sample of school-aged children.
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Affiliation(s)
- M H G Dremmen
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
| | - R H Bouhuis
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
| | - L M E Blanken
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Generation R Study Group (L.M.E.B., R.L.M., H.E.M.), Erasmus Medical Center-Sophia, Rotterdam, the Netherlands
| | - R L Muetzel
- Epidemiology (R.L.M., M.W.V., V.W.V.J.)
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Generation R Study Group (L.M.E.B., R.L.M., H.E.M.), Erasmus Medical Center-Sophia, Rotterdam, the Netherlands
| | - M W Vernooij
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
- Epidemiology (R.L.M., M.W.V., V.W.V.J.)
| | - H E Marroun
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Generation R Study Group (L.M.E.B., R.L.M., H.E.M.), Erasmus Medical Center-Sophia, Rotterdam, the Netherlands
| | - V W V Jaddoe
- Epidemiology (R.L.M., M.W.V., V.W.V.J.)
- Pediatrics (V.W.V.J.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Department of Clinical Medicine (F.C.V.), University of Copenhagen, Copenhagen, Denmark
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Harvard School of Public Health (H.T.), Boston, Massachusetts
| | - T White
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
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Beraldi GH, Prado KS, Amann BL, Radua J, Friedman L, Elkis H. Meta-analyses of cavum septum pellucidum in mood disorders in comparison with healthy controls or schizophrenia. Eur Neuropsychopharmacol 2018; 28:1325-1338. [PMID: 30472163 DOI: 10.1016/j.euroneuro.2018.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 08/29/2018] [Accepted: 10/04/2018] [Indexed: 11/17/2022]
Abstract
The cavum septum pellucidum (CSP) is a neurodevelopmental abnormality significantly more prevalent in subjects with schizophrenia (SCZ) than in healthy controls (HC). Using meta-analyses, we tested the hypotheses whether CSP would be more frequent in subjects with mood disorders when compared with HC or SCZ. We performed a search in MEDLINE and EMBASE followed by 10 meta-analyses of magnetic resonance imaging studies which examined the association of CSP in bipolar disorders (BD), major depressive disorder (MDD) or mood disorders (MD; considering MDD and BD combined) with either HC or SCZ. Nine studies were included, comprising 692 cases (363 with BD, 182 with MDD and 147 with MD), 463 with SCZ and 630 HC. CSP of any size was significantly associated with BD (OR = 2.07, 95% CI: 1.48-2.90) when compared with HC. Large CSP showed a trend to be associated with BD when compared with HC, but the association was not statistically significant (OR = 1.92, 95% CI 0.64-5.78). Large CSP was significantly associated with subjects with SCZ when compared with subjects with MD (OR = 0.57, 95% CI: 0.36-0.92). There was no association between CSP and MDD in comparison to HC or subjects with SCZ. Cortical structures are known to be altered in mood disorders. The present metanalysis found that certain midline brain abnormalities, such as CSP, are also associated with BD.
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Affiliation(s)
- Gabriel H Beraldi
- Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Kelly S Prado
- Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Autonomous University of Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Joaquim Radua
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; FIDMAG Germanes Hospitalaries, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Lee Friedman
- Department of Computer Science, Texas State University, San Marcos, TX, US
| | - Helio Elkis
- Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
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5
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Liu H, Li L, Shen L, Wang X, Hou Y, Zhao Z, Gu L, Mao J. Cavum septum pellucidum and first-episode psychosis: A meta-analysis. PLoS One 2017; 12:e0177715. [PMID: 28545119 PMCID: PMC5435239 DOI: 10.1371/journal.pone.0177715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/02/2017] [Indexed: 02/05/2023] Open
Abstract
Objectives To investigate the prevalence and changes of cavum septum pellucidum (CSP) in first-episode psychosis (FEP) patients. Methods Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify eligible studies comparing FEP patients and healthy controls from inception to Feb 29, 2016. Results Ten cross-sectional studies and three longitudinal studies reported in ten articles met our criteria. Our meta-analysis found no significant differences in the prevalence of either “any CSP” (OR = 1.41; 95% CI 0.90–2.20; p = 0.13; I2 = 52.7%) or “large CSP” (OR = 1.10; 95% CI 0.77–1.58; p = 0.59; I2 = 24.1%) between FEP patients and healthy controls. However, the heterogeneity analysis of the prevalence of “any CSP” suggested bias in outcome reporting. Conclusions The results based on current evidence suggest it is unclear whether “any CSP” is a risk factor for FEP due to the heterogeneity of the studies. There is insufficient evidence to support that “large CSP” is a possible risk factor for FEP.
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Affiliation(s)
- Hanwen Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Internal Medicine Unit, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ling Li
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Shen
- Department of Psychosomatic Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xianliang Wang
- Cardiovascular Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yazhu Hou
- Cardiovascular Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhiqiang Zhao
- Cardiovascular Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lili Gu
- Department of Medical Administration, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingyuan Mao
- Internal Medicine Unit, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- * E-mail:
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6
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Koerte IK, Hufschmidt J, Muehlmann M, Tripodis Y, Stamm JM, Pasternak O, Giwerc MY, Coleman MJ, Baugh CM, Fritts NG, Heinen F, Lin A, Stern RA, Shenton ME. Cavum Septi Pellucidi in Symptomatic Former Professional Football Players. J Neurotrauma 2015; 33:346-53. [PMID: 26414478 DOI: 10.1089/neu.2015.3880] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventy-two symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p < 0.0001; septum length: rho = 0.93; ICC 0.96; p < 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p < 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall, p = 0.04) and decreased test scores on a measure of estimate verbal intelligence (Wide Range Achievement Test Fourth Edition Reading Test, p = 0.02). Given the high prevalence of CSP in neuropathologically confirmed CTE in addition to the results of this study, CSP may serve as a potential early in vivo imaging marker to identify those at high risk for CTE. Future research is needed to investigate the pathomechanism underlying the development of CSP after repetitive head impacts, and its potential association with neuropathologically confirmed CTE.
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Affiliation(s)
- Inga K Koerte
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,2 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Jakob Hufschmidt
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,3 Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-University , Munich, Germany
| | - Marc Muehlmann
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,2 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilian-University , Munich, Germany
| | - Yorghos Tripodis
- 4 Department of Biostatistics, Boston University School of Public Health , Boston, Massachusetts.,5 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,6 Alzheimer's Disease Center, Boston University School of Medicine , Boston, Massachusetts
| | - Julie M Stamm
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,5 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,7 Department of Anatomy and Neurobiology, Boston University School of Medicine , Boston, Massachusetts
| | - Ofer Pasternak
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
| | - Michelle Y Giwerc
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
| | - Michael J Coleman
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
| | - Christine M Baugh
- 5 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,8 Interfaculty Initiative in Health Policy, Harvard University , Cambridge, Massachusetts
| | - Nathan G Fritts
- 5 CTE Center, Boston University School of Medicine , Boston, Massachusetts
| | - Florian Heinen
- 3 Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-University , Munich, Germany
| | - Alexander Lin
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,9 Department of Radiology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,10 Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts
| | - Robert A Stern
- 5 CTE Center, Boston University School of Medicine , Boston, Massachusetts.,6 Alzheimer's Disease Center, Boston University School of Medicine , Boston, Massachusetts.,7 Department of Anatomy and Neurobiology, Boston University School of Medicine , Boston, Massachusetts.,11 Departments of Neurology and Neurosurgery, Boston University School of Medicine , Boston, Massachusetts
| | - Martha E Shenton
- 1 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,9 Department of Radiology, Brigham and Women's Hospital , Harvard Medical School, Boston, Massachusetts.,12 VA Boston Healthcare System , Brockton Division, Brockton, Massachusetts
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7
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Clinical correlates of enlarged cavum septum pellucidum in schizophrenia: A revisit through computed tomography. Asian J Psychiatr 2015; 15:21-4. [PMID: 26001900 DOI: 10.1016/j.ajp.2015.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/28/2015] [Accepted: 04/01/2015] [Indexed: 11/22/2022]
Abstract
Like prevalence of abnormal cavum septum pellucidum in patients of schizophrenia remains controversial, its role in clinical outcome, duration of illness and effect on treatment remains less understood as well. Our study examined clinical correlates of enlarged cavum septum pellucidum in schizophrenia. A total of 139 patients diagnosed with schizophrenia during the year 2012 and 2013 were taken for the study. We compared them in respect to the presence and absence of enlarged cavum septum pellucidum. We found 16 patients with enlarged cavum septum pellucidum and were compared with those without enlarged cavum septum pellucidum for socio-demographic and clinical variables. We also correlated these clinical variables with dimension of cavum septum pellucidum. We found statistically significant increased current age and duration of illness in patients with enlarged cavum septum pellucidum. The implications of these findings are discussed with possible confounding effect of current age on neuroimaging. No meaningful correlation was found. No difference in clinical variables was found. Retrospective design and use of computed tomography were limitation of our study.
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8
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Akinola RA, Idowu OE, Nelson-Paseda AO. Caval variations in neurologically diseased patients. Acta Radiol Short Rep 2014; 3:2047981614530288. [PMID: 25298867 PMCID: PMC4184453 DOI: 10.1177/2047981614530288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/12/2014] [Indexed: 11/30/2022] Open
Abstract
Background The import of the cavum variation and its prevalence rate in healthy individuals is still not clear, likewise in neurologically diseased patients. Purpose To evaluate the frequency and pattern of caval variations in neurologically diseased patients. Material and Methods The presence or absence of the cavum septum pellucidum (CSP), cavum vergae (CV), or cavum velum interpositum (CVI) was reviewed from successive cranial computerized tomography (CT) images of patients who were aged 6 months and above. Two hundred and seventeen cranial CT images were reviewed. Results At least a cavum variation was noted in 130 (59.9%) of the CT scan images reviewed. The CV, CVI, and CSP were noted in 86 (39.6%), 53 (24.4%), and 50 images (23%), respectively. Caval multiplicity was noted in 102 patients (47%). There was no significant difference in the rate of occurrence of cavum variations in patients with congenital brain diseases and acquired brain conditions (P = 0.484), neither was there a significant difference in the frequency of cavum variation in children aged older than 6 months compared to adults (P = 0.101). Conclusion Cava variations are relatively common in neurological brain diseases. Patients with congenital brain diseases did not have a higher frequency of cava variation when compared with those that had acquired lesions. The most common type of cavum variation noted in this study was the vergae variety, while the CSP is the rarest.
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Affiliation(s)
- Rachael A Akinola
- Department of Radiology, Lagos State University College of Medicine and Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Olufemi E Idowu
- Department of Surgery (Neurosurgery Unit), Lagos State University College of Medicine and Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Adedolapo O Nelson-Paseda
- Department of Radiology, Lagos State University College of Medicine and Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
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Trzesniak C, Oliveira IR, Kempton MJ, Galvão-de Almeida A, Chagas MHN, Ferrari MCF, Filho AS, Zuardi AW, Prado DA, Busatto GF, McGuire PK, Hallak JEC, Crippa JAS. Are cavum septum pellucidum abnormalities more common in schizophrenia spectrum disorders? A systematic review and meta-analysis. Schizophr Res 2011; 125:1-12. [PMID: 20965698 DOI: 10.1016/j.schres.2010.09.016] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 09/07/2010] [Accepted: 09/23/2010] [Indexed: 10/18/2022]
Abstract
Magnetic resonance imaging (MRI) studies have reported a variety of brain abnormalities in association with schizophrenia. These include a higher incidence of cavum septum pellucidum (CSP), which is consistent with a neurodevelopmental model for this disorder. In this meta-analytic review, we describe and discuss the main CSP MRI findings in schizophrenia spectrum disorders (SSDs) to date. We adopted as keywords cavum and schizophrenia or psychosis, and the inclusion criteria were articles in English, with samples of SSD patients compared to healthy subjects, which used MRI to assess CSP, without time limit. From 18 potential reports, fifteen were eligible to be part of the current review. These studies included 1054 patients with SSD and 866 healthy volunteers. Six out of 15 studies pointed to a higher prevalence of CSP of any size in SSD patients, while five out of 15 showed that subjects with SSD had a greater occurrence of a large CSP than healthy individuals. However, the meta-analysis demonstrated that only the incidence of a large CSP was significantly higher in SSD relative to healthy comparisons (odds ratio=1.59; 95%CI 1.07-2.38; p=0.02). Overall our results suggest that only a large CSP is associated with SSD while a small CSP may be considered a normal neuroanatomical variation. Our review revealed a large degree of variability in the methods employed across the MRI studies published to date, as well as evidence of publication bias. Studies in large, community-based samples with greater standardization of methods should clarify the true significance of CSP in SSD.
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Affiliation(s)
- Clarissa Trzesniak
- Department of Neuroscience and Behavior, Medical School, University of São Paulo (USP), Ribeirão Preto (SP), Brazil and INCT Translational Medicine, Brazil.
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Takahashi T, Yücel M, Lorenzetti V, Nakamura K, Whittle S, Walterfang M, Suzuki M, Pantelis C, Allen NB. Midline brain structures in patients with current and remitted major depression. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:1058-63. [PMID: 19505522 DOI: 10.1016/j.pnpbp.2009.05.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 05/25/2009] [Accepted: 05/26/2009] [Indexed: 11/26/2022]
Abstract
Brain morphologic changes of limbic-cortical regions have been reported in major depressive disorder (MDD). However, it remains largely unknown whether MDD is associated with abnormalities in midline brain structures, which play a critical role in limbic-cortical connectivity, and whether such changes reflect state or trait markers of the disorder. We used magnetic resonance imaging to investigate the length of the adhesio interthalamica (AI) and cavum septum pellucidum (CSP) in 29 currently depressed patients, 27 remitted depressed patients, and 33 age- and gender-matched healthy control subjects. The currently depressed patients had a significantly shorter AI compared with controls, but there was no difference in the AI length between the remitted patients and controls. The AI length in the overall patient group was negatively correlated with the severity of symptoms of "loss of interest" at the time of scanning. Furthermore, the patients with co-morbid anxiety disorders tended to have a shorter AI compared with those without. The CSP length and prevalence of a large CSP (>or=6 mm) did not differ between the groups. Although a comprehensive investigation of medication effects was not possible due to incomplete medication data, these findings suggest that a shorter length of the AI may be associated with state-related brain changes in major depression rather than a stable marker of illness vulnerability. Whether the AI length exhibits ongoing changes across the course of the illness remains to be determined in longitudinal studies.
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Affiliation(s)
- Tsutomu Takahashi
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia.
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11
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Takahashi T, Yung AR, Yücel M, Wood SJ, Phillips LJ, Harding IH, Soulsby B, McGorry PD, Suzuki M, Velakoulis D, Pantelis C. Prevalence of large cavum septi pellucidi in ultra high-risk individuals and patients with psychotic disorders. Schizophr Res 2008; 105:236-44. [PMID: 18693084 DOI: 10.1016/j.schres.2008.06.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 06/24/2008] [Accepted: 06/30/2008] [Indexed: 10/21/2022]
Abstract
An increased prevalence of large cavum septum pellucidum (CSP), a marker of midline neurodevelopmental abnormality, has been reported in schizophrenia. However, not all studies have been able to replicate this finding and very few studies have been conducted in large samples. In the current study, magnetic resonance imaging was used to assess the presence of an abnormal CSP in 162 patients with first-episode psychosis (FEP), 89 patients with chronic schizophrenia, 135 ultra high-risk (UHR) individuals, and 87 controls. The prevalence of a large CSP (>5.6 mm) did not differ between the groups (9.3% of the FEP patients, 11.2% of the chronic schizophrenia patients, 11.1% of the UHR individuals, and 11.5% of the controls). The length of the CSP was not associated with sulcal morphology of the anterior cingulate cortex (ACC), suggesting different biological processes responsible for the CSP enlargement versus ACC folding. These findings suggest that the CSP is not a neurodevelopmental marker of psychosis and cast doubt over the notion that it plays a major role in the neurobiology of psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia.
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12
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Souweidane MM, Hoffman CE, Schwartz TH. Transcavum interforniceal endoscopic surgery of the third ventricle. J Neurosurg Pediatr 2008; 2:231-6. [PMID: 18831654 DOI: 10.3171/ped.2008.2.10.231] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECT Intraventricular anatomy has been detailed as it pertains to endoscopic surgery within the third ventricle, particularly for performing endoscopic third ventriculostomy (ETV) and endoscopic colloid cyst resection. The expanding role of endoscopic surgery warrants a careful appraisal of these techniques as they relate to frequent anatomical variants. Given the common occurrence of cavum septum pellucidum (CSP) and cavum vergae (CV), the endoscopic surgeon should be familiar with that particular anatomy especially as it pertains to surgery within the third ventricle. METHODS From a prospective database of endoscopic surgical cases were selected those cases in which the defined pathology necessitated surgery within the third ventricle and there was coexistent CSP and CV. Pertinent radiographic studies, operative notes, and archived video files were reviewed to define the relevant anatomy. Features of the intracavitary anatomy were assessed regarding their importance in approaching the third ventricle. RESULTS Four cases involving endoscopic surgery within the third ventricle (2 colloid cyst resections and 2 ETVs) were identified in which the surgical objective was accomplished through a septal cavum. In each case the width of the body of the lateral ventricle was reduced and the foramen of Monro was obscured. Because of the ventricular distortion, a stereotactic transcavum route was used for approaching the third ventricle. Entry into the third ventricle was accomplished through an interforniceal fenestration immediately behind the anterior commissure. The surgical goal was met in each case without any neurological change or postoperative morbidity. During the follow-up period, there has been no recurrence of a colloid cyst and no need of a secondary cerebrospinal fluid diversionary procedure. CONCLUSIONS In the presence of a CSP and CV, endoscopic navigation into the third ventricle can be problematic via a transforaminal approach. Alternatively, a transcavum interforniceal route for endoscopic surgery in the third ventricle is suggested, with the rostral lamina and the anterior commissure as important anatomical landmarks. Endoscopic third ventriculostomy and endoscopic colloid cyst resection performed via a transcavum interforniceal route in patients with a coexistent septal cavum is a feasible and safe option.
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Affiliation(s)
- Mark M Souweidane
- Department of Neurological Surgery, Weill Medical College of Cornell University and Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
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13
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Rajarethinam R, Sohi J, Arfken C, Keshavan MS. No difference in the prevalence of cavum septum pellucidum (CSP) between first-episode schizophrenia patients, offspring of schizophrenia patients and healthy controls. Schizophr Res 2008; 103:22-5. [PMID: 18248791 DOI: 10.1016/j.schres.2007.11.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Revised: 11/15/2007] [Accepted: 11/19/2007] [Indexed: 11/29/2022]
Abstract
The reported prevalence of cavum septum pellucidum (CSP), is extremely variable (from 0.1% to 85%) depending upon the measurement method or imaging resolution. Higher prevalence of CSP has been found in schizophrenia. In this study, we examined the prevalence of CSP in a large number of first-episode schizophrenia patients, young relatives of schizophrenia patients and healthy controls. We manually measured CSP using 1.5 mm T1 MRI scans from ongoing studies at University of Pittsburgh in 89 first-episode patients with schizophrenia (age=23.8+/-7.4, M/F=61/28), 64 genetically at-risk individuals (offspring and siblings of schizophrenia patients, age 15.2+/-3.7, M/F=29/32) and 120 comparison subjects (n=120, age=22.1+/-7.9, M/F62/50). CSP was present in 64% of the first-episode patients (mean length 1.87+/-2.3 mm), 64.6% of the at-risk individuals (1.64+/-1.96 mm) and 64.2% of the normal controls (1.88+/-2.0 mm). There was no difference in the prevalence of CSP exceeding 4 mm. We also did not find any influence of the sex or age in the presence or size of CSP. Our data cast doubt on the significance of CSP as markers of neurodevelopmental pathology in schizophrenia.
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Affiliation(s)
- Rajaprabhakaran Rajarethinam
- Brain Research and Imaging Neuroscience, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 4201, St Antoine street, Detroit, MI 48201, USA.
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14
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Choi JS, Kang DH, Park JY, Jung WH, Choi CH, Chon MW, Jung MH, Lee JM, Kwon JS. Cavum septum pellucidum in subjects at ultra-high risk for psychosis: compared with first-degree relatives of patients with schizophrenia and healthy volunteers. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1326-30. [PMID: 18513845 DOI: 10.1016/j.pnpbp.2008.04.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2008] [Revised: 04/12/2008] [Accepted: 04/15/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The cavum septum pellucidum (CSP) is a space between the two leaflets of the septum pellucidum, and is a putative marker of disturbance in early brain development. We examined whether CSP was present more frequently in subjects at ultra-high risk (UHR) for psychosis compared to first-degree relatives of patients with schizophrenia (genetic high risk, GHR) and healthy controls (HC). METHODS We evaluated CSP in 87 subjects (30 UHR, 23 GHR, and 34 HC) according to a published grading system using high-resolution magnetic resonance imaging (MRI) with 0.45-mm slice thickness. We also assessed two other criteria: presence of CSP on at least one MRI slice, and abnormally large CSP (i.e., > or =6 mm in length). Correlational analysis between CSP measures and clinical symptoms was also examined. RESULTS Based on the grading scale, the UHR group exhibited a significantly higher incidence of abnormal CSP (grades 2, 3, and 4) compared to the HC group, but there were no significant differences in the incidence of abnormal CSP between the UHR and GHR or the GHR and HC groups. There were no significant differences among the groups in the presence of CSP on at least one MRI slice or abnormally large CSP based on the length of CSP. In addition, no significant correlations between CSP measures and clinical symptoms were found. CONCLUSION These findings suggest that abnormal CSP might be associated with susceptibility to psychosis, although the CSP itself might be a normal anatomical variant. Further studies using a larger sample are needed to clarify issues on neurodevelopmental perspective in subjects at high risk for psychosis.
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Affiliation(s)
- Jung-Seok Choi
- Department of Psychiatry, Seoul National University College of Medicine and Clinical Cognitive Neuroscience Center, SNU-MRC, Seoul, Republic of Korea
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15
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Takahashi T, Suzuki M, Hagino H, Niu L, Zhou SY, Nakamura K, Tanino R, Kawasaki Y, Seto H, Kurachi M. Prevalence of large cavum septi pellucidi and its relation to the medial temporal lobe structures in schizophrenia spectrum. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:1235-41. [PMID: 17553605 DOI: 10.1016/j.pnpbp.2007.04.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Revised: 04/02/2007] [Accepted: 04/30/2007] [Indexed: 11/29/2022]
Abstract
Magnetic resonance imaging was used to evaluate the prevalence of the cavum septi pellucidi (CSP) in 154 schizophrenia patients, 47 schizotypal disorder patients, and 163 healthy controls. We also explored the relation of a large CSP (> or =6 mm) with medial temporal lobe structures. No significant difference was found in the prevalence of the CSP (76.0% of the schizophrenia patients, 81.6% of the controls, and 85.1% of the schizotypal patients) or the large CSP (6.5% of the schizophrenia patients, 7.4% of the controls, and 10.6% of the schizotypal patients) among the groups, but patients with a large CSP (10 schizophrenia and 5 schizotypal patients) had smaller volumes of bilateral amygdala and left posterior parahippocampal gyrus than patients without it. In the control subjects, the large CSP did not affect the volumes of the medial temporal lobe structures. These findings might reflect neurodevelopmental abnormalities in midline and associated limbic structures of the brain in schizophrenia spectrum.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
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16
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Brisch R, Bernstein HG, Krell D, Stauch R, Trübner K, Dobrowolny H, Kropf S, Bielau H, Bogerts B. Volumetric analysis of septal region in schizophrenia and affective disorder. Eur Arch Psychiatry Clin Neurosci 2007; 257:140-8. [PMID: 17180571 DOI: 10.1007/s00406-006-0697-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Accepted: 08/28/2006] [Indexed: 10/23/2022]
Abstract
MRI and post-mortem studies indicate an increased prevalence of cavum septi pellucidi (CSP) in schizophrenia and affective disorder. The aim of this study was to characterize the CSP and the septal tissue among patients with schizophrenia, patients with affective disorder, and control subjects. The volumes of CSP and septal tissue were measured in post-mortem brains in 42 patients with schizophrenia, 14 patients with affective disorder, and 17 normal control cases by planimetry of serial sections. Enlargements of CSP (>100 mm(3)) were found in eight of the 42 (19%) patients with schizophrenia. There were no significant differences in CSP volumes between patients with affective disorder and controls. Enlarged CSP in schizophrenia were not associated with reduced septal tissue volumes. By contrast, a significant positive correlation between volumes of CSP and septal tissue volumes in patients with schizophrenia (P = 0.03) and in control cases (P < 0.01) was found, but not in patients with affective disorder (P = 0.53). The finding of enlarged CSP in schizophrenia strongly supports the hypothesis of an early developmental abnormality in this key structure of the limbic system.
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Affiliation(s)
- Ralf Brisch
- Dept. of Psychiatry, Psychotherapy and Psychosomatic Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
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17
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Flashman LA, Roth RM, Pixley HS, Cleavinger HB, McAllister TW, Vidaver R, Saykin AJ. Cavum septum pellucidum in schizophrenia: clinical and neuropsychological correlates. Psychiatry Res 2007; 154:147-55. [PMID: 17291728 PMCID: PMC1858669 DOI: 10.1016/j.pscychresns.2006.09.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2005] [Revised: 07/07/2006] [Accepted: 09/07/2006] [Indexed: 12/01/2022]
Abstract
Increased frequency of cavum septum pellucidum (CSP) has been inconsistently observed in schizophrenia, and little is known about its functional implications. We investigated whether patients with schizophrenia were more likely than healthy controls to have CSP, and among patients assessed the relationship between CSP, psychiatric symptoms, and selected neuropsychological functions. Seventy-seven patients with diagnoses of DSM-IV schizophrenia spectrum disorders and 55 healthy controls were studied and completed a 1.5 T MRI scan. Two raters, blind to group membership, determined the presence, length and grade of the CSP. A subset of participants also underwent neuropsychological testing. A CSP of at least 1 mm in length was present in 68.8% of patients and 76.4% of controls, and the groups did not differ significantly with respect to presence or absence, length, overall size, or percent with an abnormally large CSP (> or =6 mm). Patients with an abnormally large CSP demonstrated poorer performance on measures of verbal learning and memory than patients with smaller CSP. Among patients, CSP length was significantly correlated with negative symptoms, verbal learning, and sentence comprehension. Among patients with abnormally large CSP, CSP length was correlated with reaction time on two conditions of a Continuous Performance Test. CSP, while prevalent, was not more frequent in our sample of patients with schizophrenia, and had few associations with symptom severity or neuropsychological deficits.
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Affiliation(s)
- Laura A Flashman
- Neuropsychology Program and Brain Imaging Laboratory, Department of Psychiatry, Dartmouth Medical School, and New Hampshire Hospital, Lebanon, NH, USA.
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18
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Filipovic B, Ilankovic N, Radonjic V, Filipovic B, Nikolic V. Large cava septi pellucidi in schizophrenic patients, alcoholics, head-traumatized, and normal individuals: morpholgical features and forensic implications. A postmortem study. Acta Neuropsychiatr 2006; 18:15-20. [PMID: 26991977 DOI: 10.1111/j.0924-2708.2006.00112.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The enlarged cava septi pellucidi (CSP = 6 mm in length) have been reported as a reliable marker of an underlying neuropsychiatric disease or disorder. Differences in the dimensions of cava longer than 6 mm associated with a neuropsychiatric impairment could be of possible clinical and forensic significance. METHODS We obtained 479 brains from autopsied persons (310 males and 169 females, aged 22-89 years) and observed that 110 brains (75 males and 35 females) had CSP, of which the length of CSP was equal to or longer than 6 mm on 69 (49 males and 20 females) of them. These cava were classified into four groups depending on the past medical histories of the autopsied person: five without neuropsychiatric history (asymptomatic CSP), 25 schizophrenic patients, 22 alcoholics, and 17 with a past head trauma (symptomatic CSP). RESULTS The linear parameters of CSP (i.e. length, width) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis revealed that the cava in the group of schizophrenic patients were significantly longer and wider. CONCLUSIONS Discriminant function analysis was used to derive a mathematical formula to classify CSP into one of the groups obtained based on width measurements of the cavum.
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Affiliation(s)
- B Filipovic
- 1Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - N Ilankovic
- 2Department for Organic Mental Disorders, Institute of Psychiatry, Clinical Center of Serbia, Belgrade, Serbia
| | - V Radonjic
- 1Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - B Filipovic
- 3Clinical Center 'Bezanijska Kosa', Belgrade, Serbia
| | - V Nikolic
- 1Institute of Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia
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Borgwardt SJ, Radue EW, Götz K, Aston J, Drewe M, Gschwandtner U, Haller S, Pflüger M, Stieglitz RD, McGuire PK, Riecher-Rössler A. Radiological findings in individuals at high risk of psychosis. J Neurol Neurosurg Psychiatry 2006; 77:229-33. [PMID: 16421128 PMCID: PMC2077602 DOI: 10.1136/jnnp.2005.069690] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the prevalence of radiological magnetic resonance imaging (MRI) findings in individuals at high risk of schizophrenia. METHODS MRI scans from individuals at high risk of schizophrenia (HR; n = 37) were assessed by a radiologist blind to group status and compared with scans from patients with first episode psychosis (FE; n = 30), depressive controls (DC; n = 17), and healthy controls (HC; n = 26). RESULTS There was a significantly higher proportion of radiological findings in individuals at high risk of schizophrenia (35%) and patients with first-episode psychosis (40%) than in patients with depression (18%) or healthy controls (12%). These differences were specific to findings regarded as potentially clinically significant as opposed to normal variants; however, there was no indication for medical treatment. CONCLUSIONS The results suggest that a large proportion of those at high risk of psychosis have radiological findings on MRI scanning, and that the prevalence of radiological findings in this group is similar to that in patients with first episode psychosis.
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Affiliation(s)
- S J Borgwardt
- Psychiatric Outpatient Department, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland
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Filipović B, Teofilovski-Parapid G. Linear parameters of normal and abnormal cava septi pellucidi: a post-mortem study. Clin Anat 2005; 17:626-30. [PMID: 15494969 DOI: 10.1002/ca.20014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anatomical variations in the dimensions of different brain structures have been correlated with clinical syndromes. This study on the parameters of normal and abnormal cavum septi pellucidi (CSP) can be of clinical significance. We obtained 479 brains from autopsied persons (310 males and 169 females, 377 normal or asymptomatic and 102 abnormal or symptomatic persons, aged 22-89 years) and observed that 110 brains (75 males and 35 females) had CSP. These cava were classified into two groups depending on the past medical histories of the autopsied person: 40 asymptomatic and 70 symptomatic cava. We have defined symptomatic cava as those in autopsied persons who had known past medical history of psychiatric or neurological disease. Asymptomatic cava were in autopsied persons who had no known past medical history of psychiatric or neurological disease. The CSP parameters (length, width, depth) of the symptomatic and asymptomatic groups were measured and were statistically analyzed. Analysis showed that the cava in the symptomatic group were significantly longer and wider. Discriminant function analysis was used to derive a mathematical formula to classify CSP into an asymptomatic or symptomatic group based on length and width measurements of the cavum.
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Affiliation(s)
- Branislav Filipović
- Institute of Anatomy, School of Medicine University of Belgrade, Serbia, Montenegro, 11000 Yugoslavia.
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21
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Filipović B, Kovacević S, Stojicić M, Prostran M, Filipović B. Morphological differences among cavum septi pellucidi obtained in patients with schizophrenia and healthy individuals: forensic implications. A post-mortem study. Psychiatry Clin Neurosci 2005; 59:106-8. [PMID: 15679549 DOI: 10.1111/j.1440-1819.2005.01341.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cavum septi pellucidi (CSP), especially when longer than 6 mm, has been recognized as a neurodevelopmental anomaly associated with schizophrenia. The present post-mortem study was designed to determine the importance of linear parameters of CSP and to evaluate the possible differences of CSP in schizophrenic patients (n=25 out of 110 CSP+ brains) and normal persons (n=40 out of 110 CSP+ brains). According to our results, schizophrenia patients had significantly longer and wider CSP than normal individuals. Also, statistical analysis revealed a higher suicide rate in CSP-positive patients with schizophrenia.
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Affiliation(s)
- Branislav Filipović
- Institute of Anatomy, University of Belgrade, Belgrade, Serbia and Montenegro.
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22
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Kasai K, McCarley RW, Salisbury DF, Onitsuka T, Demeo S, Yurgelun-Todd D, Kikinis R, Jolesz FA, Shenton ME. Cavum septi pellucidi in first-episode schizophrenia and first-episode affective psychosis: an MRI study. Schizophr Res 2004; 71:65-76. [PMID: 15374574 PMCID: PMC2811876 DOI: 10.1016/j.schres.2003.12.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2003] [Revised: 12/10/2003] [Accepted: 12/12/2003] [Indexed: 11/18/2022]
Abstract
A high prevalence of abnormal cavum septi pellucidi (CSP) in schizophrenia may reflect neurodevelopmental abnormalities in midline structures of the brain. The relationship, however, between abnormal CSP and clinical symptoms, and with abnormalities in other limbic structures remains unclear, as does the question of whether a similar abnormality is present in affective psychosis. Seventy-four patients at their first hospitalization, 33 with schizophrenia and 41 with affective (mainly manic) psychosis, and 56 healthy control subjects underwent high-spatial-resolution magnetic resonance imaging (MRI). CSP on six slices or more on 0.9375-mm resampled coronal images was categorized as abnormal. The prevalence of abnormal CSP in both schizophrenic patients (26.1%) and affective psychosis patients (18.2%) was significantly higher than was observed in control subjects (8.2%). In schizophrenic patients only, larger CSP was significantly associated with more severe thinking disturbance and smaller left parahippocampal gyrus gray matter volumes. While the relationships between CSP ratings and clinical symptoms did not significantly differ between the two psychosis groups as assessed by the comparison of regression slopes, the association with limbic volumes appeared to be specific to schizophrenic patients. These results suggest that psychosis associated with schizophrenia and affective disorder share, at least to some extent, neurodevelopmental abnormalities involving midline structures and associated psychopathological consequences. However, the association between abnormal CSP and limbic systems may be more specific to schizophrenia.
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Affiliation(s)
- Kiyoto Kasai
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, 940 Belmont St., Brockton, MA 02301, USA
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Robert W. McCarley
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, 940 Belmont St., Brockton, MA 02301, USA
- Corresponding authors. Department of Psychiatry (116A), Boston VA Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., VAMC Brockton, MA 02301, USA. Tel.: +1-508-583-4500x3723 or x2473; fax: +1-508-586-0894. (R.W. McCarley), (M.E. Shenton)
| | - Dean F. Salisbury
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, 940 Belmont St., Brockton, MA 02301, USA
- Cognitive Neuroscience Laboratory, McLean Hospital, 115 Mill St., Belmont, MA 02478, USA
| | - Toshiaki Onitsuka
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, 940 Belmont St., Brockton, MA 02301, USA
| | - Susan Demeo
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, 940 Belmont St., Brockton, MA 02301, USA
| | | | - Ron Kikinis
- Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Department of Radiology, Harvard Medical School, 75 Francis St., Boston, MA 02115, USA
| | - Ferenc A. Jolesz
- Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Department of Radiology, Harvard Medical School, 75 Francis St., Boston, MA 02115, USA
| | - Martha E. Shenton
- Laboratory of Neuroscience, Clinical Neuroscience Division, Department of Psychiatry, Boston VA Healthcare System, Brockton Division, and Harvard Medical School, 940 Belmont St., Brockton, MA 02301, USA
- Surgical Planning Laboratory, MRI Division, Brigham and Women’s Hospital, Department of Radiology, Harvard Medical School, 75 Francis St., Boston, MA 02115, USA
- Corresponding authors. Department of Psychiatry (116A), Boston VA Healthcare System, Brockton Division, Harvard Medical School, 940 Belmont St., VAMC Brockton, MA 02301, USA. Tel.: +1-508-583-4500x3723 or x2473; fax: +1-508-586-0894. (R.W. McCarley), (M.E. Shenton)
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Filipović B, Prostran M, Ilanković N, Filipović B. Predictive potential of cavum septi pellucidi (CSP) in schizophrenics, alcoholics and persons with past head trauma. A post-mortem study. Eur Arch Psychiatry Clin Neurosci 2004; 254:228-30. [PMID: 15309391 DOI: 10.1007/s00406-004-0483-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2003] [Accepted: 12/03/2003] [Indexed: 11/24/2022]
Abstract
The increased presence of cavum septi pellucidi (CSP) was reported among people suffering from schizophrenia, alcoholism or it could be a remnant of an old head trauma. We have tried to compare not only prevalences, but also lengths, widths and depths of the obtained cava in an effort to emphasize the importance of linear parameters in routine diagnostics. On 479 cadavers, 310 male and 169 female, aged 22 to 89; 110 brains had a CSP: 40 persons had no data about prior neuropsychiatric disease, 25 were schizophrenics, 25 alcoholics and 20 received a serious head blow during their lifetime. The prevalence of CSP in the entire group was 22.96%; among normal persons 10.61%; in schizophrenics 83.33%, in alcoholics 58.14 % and in persons with sustained prior head trauma 68.96%. There was a statistically significant difference in ratings, lengths and widths of CSP between schizophrenics, alcoholics, head traumatized and normals. Both length and width were revealed as parameters of importance for CSP selection. CSP is more frequent, longer and wider in persons who are suffering from schizophrenia, alcohol addicts and those who had sustained one or several head blows in the past. Its linear parameters are advisable to be measured.
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Affiliation(s)
- Branislav Filipović
- Institute of Anatomy, 4/2 Dr Subotica, 11000 Beograd, Serbia and Montenegro.
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May FS, Chen QC, Gilbertson MW, Shenton ME, Pitman RK. Cavum septum pellucidum in monozygotic twins discordant for combat exposure: relationship to posttraumatic stress disorder. Biol Psychiatry 2004; 55:656-8. [PMID: 15013837 PMCID: PMC2794416 DOI: 10.1016/j.biopsych.2003.09.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2003] [Revised: 09/29/2003] [Accepted: 09/30/2003] [Indexed: 11/28/2022]
Abstract
BACKGROUND Abnormally large cavum septum pellucidum has been reported in posttraumatic stress disorder; however, the origin of this association is uncertain. METHODS We utilized magnetic resonance imaging to measure cavum septum pellucidum in pairs of identical twins discordant for combat exposure in Vietnam. RESULTS Presence of abnormal cavum septum pellucidum was significantly correlated between exposed and unexposed twins, indicating that it is partially determined by heredity and/or shared environment. There was a greater proportion of cavum septum pellucidum in combat-exposed twins with posttraumatic stress disorder and their noncombat-exposed co-twins. CONCLUSIONS The presence of abnormally large cavum septum pellucidum is a familial vulnerability factor for posttraumatic stress disorder.
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Affiliation(s)
- Flavia S May
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Keshavan MS, Jayakumar PN, Diwadkar VA, Singh A. Cavum septi pellucidi in first-episode patients and young relatives at risk for schizophrenia. CNS Spectr 2002; 7:155-8. [PMID: 15220858 DOI: 10.1017/s1092852900017478] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Studies on schizophrenia (SZ) have documented an increased presence of cavum septi pellucidi (CSP) in individuals suffering from the illness. Moreover, the presence of CSP has been cited in support of the early neurodevelopmental hypothesis in SZ. Our objective was to assess the magnetic resonance imaging (MRI) scans of first-episode patients and healthy controls to evaluate the frequency of CSP. The presence and the size of CSP were visually assessed on the MRI scans of 40 first-episode SZ patients, 19 nonpsychotic child and high-risk adolescent offspring of patients with SZ or schizoaffective disorder, and 59 controls. Our analysis revealed an absence of statistically significant differences in the occurrence of CSP between SZ patients, high-risk subjects, and controls. Even when the analysis was restricted to large CSP, no differences were found. Furthermore, no association between CSP and sex or handedness was observed. The absence of CSP abnormalities in first-episode SZ subjects might indicate that SZ is not characterized by developmentally mediated alterations in CSP. Also, family history of SZ might not increase likelihood for CSP.
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Affiliation(s)
- Matcheri S Keshavan
- Department of Psychiatry, the University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA.
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