Article

Superior temporal gyrus volume in antipsychotic-naive people at risk of psychosis.

Melbourne Neuropsychiatry Centre, c/o National Neuroscience Facility, 161 Barry Street, Carlton South, Victoria 3053, Australia. .
The British journal of psychiatry: the journal of mental science (Impact Factor: 6.62). 03/2010; 196(3):206-11. DOI: 10.1192/bjp.bp.109.069732
Source: PubMed

ABSTRACT Morphological abnormalities of the superior temporal gyrus have been consistently reported in schizophrenia, but the timing of their occurrence remains unclear.
To determine whether individuals exhibit superior temporal gyral changes before the onset of psychosis.
We used magnetic resonance imaging to examine grey matter volumes of the superior temporal gyrus and its subregions (planum polare, Heschl's gyrus, planum temporale, and rostral and caudal regions) in 97 antipsychotic-naive individuals at ultra-high risk of psychosis, of whom 31 subsequently developed psychosis and 66 did not, and 42 controls.
Those at risk of psychosis had significantly smaller superior temporal gyri at baseline compared with controls bilaterally, without any prominent subregional effect; however, there was no difference between those who did and did not subsequently develop psychosis.
Our findings indicate that grey matter reductions of the superior temporal gyrus are present before psychosis onset, and are not due to medication, but these baseline changes are not predictive of transition to psychosis.

0 Bookmarks
 · 
107 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Brain imaging studies in schizophrenia have typically involved single assessment and cross-sectional designs, while longitudinal studies rarely incorporate more than two time points. While informative, these studies do not adequately capture potential trajectories of neurobiological change, particularly in the context of a changing clinical picture. We propose that the analysis of brain trajectories using multiple time points may inform our understanding of the illness and the effect of treatment. This paper makes the case for frequent serial neuroimaging across the course of schizophrenia psychoses and its application to active illness epsiodes to provide a detailed examination of psychosis relapse and remission.
    Epidemiology and Psychiatric Sciences 05/2014; · 3.36 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Las psicosis de la epilepsia: presentación de un caso clínico y revisión de la literatura. The psychosis of epilepsy: a case report and literature review. Recibido: 13/08/2012; aceptado con modificaciones: 17/12/2012 RESUMEN: Presentamos el caso de un varón de 72 años con un diagnóstico previo de epilepsia del lóbu-lo temporal y esquizofrenia paranoide, que mostraba episodios de psicosis con sintomatología pleomórfica y atípica que no respondía bien al tratamiento anti-psicótico. El paciente no presentaba un deterioro en su personalidad y había demostrado un buen ajuste y funcionamiento social. Tras revisar el caso se llega a cuestionar el diagnóstico previo de esquizofrenia paranoide proponiendo el diagnóstico alternativo de epilepsia del lóbulo temporal: crisis comiciales con sintomatología psicótica. Se instaura el tratamiento adecuado con éxito lo que permite el alta del paciente a su domicilio. Revisamos la literatura en la materia, concluyendo que las psicosis de la epilepsia han de tenerse en cuenta en casos de psicosis atípicas, resis-tentes a tratamiento en personas con buen funciona-miento psico-social sin deterioro en su personalidad. PALABRAS CLAVE: epilepsia del lóbulo temporal; psicosis comiciales; psicosis de la epilepsia; psicosis de la epilepsia tipo esquizofrenia. CONFLICTO DE INTERESES: Ninguno. ABSTRACT: We describe the case of a 72 year old man with a diagnosis of temporal lobe epi-lepsy and paranoid schizophrenia, who presented atypical psychotic episodes which did not res-pond to anti-psychotic medication. His personali-ty had not deteriorated and he showed good social adjustment and functioning. After reviewing the case, we challenged the diagnosis of paranoid schizophrenia, proposing an alternative diagno-sis of temporal lobe epilepsy with ictal psycho-sis. He was successfully treated and discharged home. We review the literature on the subject. The psychosis of epilepsy are a diagnostic option which must be seriously considered in cases of treatment resistant atypical psychosis in subjects with good pre-morbid functioning and social ad-justment free from personality decline. KEY WORDS: temporal lobe epilepsy; ictal psychosis; psychosis of epilepsy; schizophrenia like psychosis of epilepsy. DECLARATION OF INTEREST: None.
    Revista de la Asociación Española de Neuropsiquiatría. 01/2013; 33:123-134.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: First episode psychosis (FEP) has been associated with structural brain changes, largely identified by volumetric analyses. Advances in neuroimaging processing have made it possible to measure geometric properties that may identify subtle structural changes not appreciated by a measure of volume alone. In this study we adopt complementary methods of assessing the structural integrity of grey matter in FEP patients and assess whether these relate to patient clinical and functional outcome at 3 year follow-up. 1.5 Tesla T1-weighted Magnetic Resonance (MR) images were acquired for 46 patients experiencing their first episode of psychosis and 46 healthy controls. Cerebral cortical thickness and local gyrification index (LGI) were investigated using FreeSurfer software. Volume and shape of the hippocampus, caudate and lateral ventricles were assessed using manual tracing and spherical harmonics applied for shape description. A cluster of cortical thinning was identified in FEP compared to controls; this was located in the right superior temporal gyrus, sulcus, extended into the middle temporal gyrus (lateral temporal cortex — LTC). Bilateral caudate volumes were significantly lower in FEP relative to controls and the right caudate also displayed regions of shape deflation in the FEP group. No significant structural abnormalities were identified in cortical LGI or hippocampal or lateral ventricle volume/shape. Neither LTC nor caudate abnormalities were related to change in symptom severity or global functioning 3 years later. LTC and caudate abnormalities are present at the first episode of psychosis but do not appear to directly affect clinical or functional outcome.
    Schizophrenia Research 01/2014; · 4.59 Impact Factor