Hypothalamus and pituitary volume in schizophrenia: a structural MRI study

The International Journal of Neuropsychopharmacology (Impact Factor: 5.64). 02/2012; 15(02):281 - 288. DOI: 10.1017/S1461145711000794

ABSTRACT Volumetric differences of the hypothalamus and/or the pituitary gland tend to support involvement of the HPA axis in psychotic disorders. These structures were manually outlined in 154 schizophrenia patients and 156 matched healthy comparison subjects by MRI brain images. Linear regression analyses were performed to investigate differences in volume between groups. Moreover, the effects of illness duration and type of medication were investigated. No significant differences were found between patients and healthy controls in volumes of the hypothalamus and pituitary gland. In addition, there were no differences in volumes between patients with short and long illness duration. There was a trend towards patients receiving typical antipsychotic medication at the time of scanning having larger pituitary volumes than patients receiving atypical medication. These findings indicate that volume decreases in brain structures important for the normal functioning of the HPA axis are not present, either in recent-onset or chronically ill patients.

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    ABSTRACT: The hypothalamus is important in hunger and metabolism. Although a lot is known about the basic role of the human hypothalamus, less is known about how the in vivo volume is affected in obesity, particularly among adolescents. Based on pediatric body mass index percentiles, 95 participants were assigned to lean or obese groups. All subjects had medical evaluations, including fasting blood tests, to assess insulin sensitivity and circulating CRP and neurotrophins (NGF and BDNF) and an MRI of the brain. Hypothalamic volumes were measured by a segmentation method combining manual and automated steps. Overall, obese participants had descriptively smaller hypothalamic volumes, although this difference did not reach statistical significance; however, among obese participants, females had significantly smaller hypothalamic volumes than their male counterparts. There was a significant interaction between insulin resistance and sex on hypothalamus volume; obese females with significant insulin resistance have smaller hypothalamic volumes than obese males. Obese adolescents had higher circulating CRP and neurotrophin levels. Furthermore, among obese females, BDNF concentrations were inversely associated with hypothalamus volumes (r = −0.48). Given this negative association between BDNF and hypothalamus volumes among obese insulin-resistant females, elevated neurotrophin levels may suggest an attempt at protective compensation.
    Disease markers 01/2013; 35(4):249-59. · 2.14 Impact Factor
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    ABSTRACT: Introduction Pituitary enlargement has been reported in individuals with schizophrenic psychosis or an at-risk mental state for psychosis (ARMS). In a previous study, our group could show pituitary volume increase in first episode and ARMS patients with later transition to psychosis (ARMS-T). However, there are no longitudinal studies on this issue so far. We therefore examined longitudinally whether transition to psychosis would be accompanied by a further increase of pituitary volume in antipsychotic-naïve ARMS patients. Magnetic resonance imaging (MRI) data were acquired from 23 antipsychotic-naïve individuals with an ARMS. Ten subjects developed psychosis (ARMS-T) and 13 did not (ARMS-NT). ARMS-T were re-scanned after the onset of psychosis, and ARMS-NT were re-scanned at the end of the study period. There was no significant difference of the pituitary volume between ARMS-T and ARMS-NT in our sample, and there were no significant pituitary volume changes over time. Discussion Longitudinally, we could not detect any further volumetric changes in the pituitary volume with transition to psychosis. This, together with the result of our previous study, could indicate that the perceived level of stress in ARMS patients is constantly high from very early onward.
    CNS spectrums 03/2014; · 1.73 Impact Factor
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    ABSTRACT: Background Hyperprolactinemia is frequent in patients with schizophrenic psychoses. It is usually regarded as an adverse effect of antipsychotics but has recently also been shown in patients without antipsychotic medication. Our objective was to test whether hyperprolactinemia occurs in antipsychotic-naive first-episode patients (FEPs).Method In the framework of the European First Episode Schizophrenia Trial (EUFEST), 249 out of 498 FEPs were eligible for this study, of whom 74 were antipsychotic naive. All patients were investigated regarding their serum prolactin levels with immunoassays standardized against the 3rd International Reference Standard 84/500.Results Twenty-nine (39%) of the 74 antipsychotic-naive patients showed hyperprolactinemia not explained by any other reason, 11 (50%) of 22 women and 18 (35%) of 52 men.Conclusions Hyperprolactinemia may be present in patients with schizophrenic psychoses independent of antipsychotic medication. It might be stress induced. As enhanced prolactin can increase dopamine release through a feedback mechanism, this could contribute to explaining how stress can trigger the outbreak of psychosis.
    Psychological Medicine 12/2013; 43(12). · 5.59 Impact Factor


Available from
May 31, 2014