Regional Gray Matter Volume Abnormalities in the At Risk Mental State

Psychiatric Outpatient Department, University Hospital Basel, Switzerland.
Biological Psychiatry (Impact Factor: 10.26). 06/2007; 61(10):1148-56. DOI: 10.1016/j.biopsych.2006.08.009
Source: PubMed


Individuals with an At Risk Mental State (ARMS) have a very high risk of developing a psychotic disorder but the basis of this risk is unclear. We addressed this issue by studying gray matter volume in this group with magnetic resonance imaging (MRI).
Thirty-five individuals with an ARMS, 25 patients with first episode schizophrenia, and 22 healthy volunteers were studied using a 1.5T MRI scanner. Twelve (34%) of the ARMS group developed schizophrenia in the 2 years subsequent to scanning.
There were significant volumetric differences between the three groups in the left insula, superior temporal gyrus, cingulate gyrus and precuneus. In these regions, the volume in the ARMS group was smaller than in volunteers but not significantly different from that in the first episode (FE) group. Direct comparison of the ARMS and control groups revealed additional areas of reduced volume in the left medial temporal cortex. Within the ARMS group, those subjects who later developed psychosis had less gray matter than subjects who did not in the right insula, inferior frontal and superior temporal gyrus.
The ARMS was associated with reductions in gray matter volume in areas that are also reduced in schizophrenia, suggesting that these are a correlate of an increased vulnerability to psychosis. Volumetric differences within the ARMS group may be related to the subsequent onset of schizophrenia in a subset of those at high risk.

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Available from: Stefan Borgwardt, Oct 04, 2015
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    • "Moreover, occipital areas were found to be engaged in detecting external threatening signals in subjects with increased anxiety (Wu, Andreescu, Figurski, Tanase, & Aizenstein, 2009). Smaller GMV in posterior PCC was reported in individuals with an " At Risk Mental State " (ARMS) compared to healthy volunteers (Borgwardt et al., 2007). These studies suggest that decreased GMV in occipital lobe and posterior PCC might lead to negative, even false observation and interpretation of emotional events and experiences resulting in reduced perceived social support. "
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    • "Cross-sectional Smaller hippocampal volume bilaterally in CHR Larger L hippocampal volume in CHR-t vs CHR-n, but no differences compared with controls Pantelis et al, 76 2003 Longitudinal Smaller GM in R medial temporal, lateral temporal, and inferior frontal and bilateral cingulate cortices at baseline CHR-t showed reduced GM in L parahippocampal, fusiform, orbitofrontal, and cerebellar cortices and cingulate gyri over time CHR-n showed reduced cerebellar GM Yucel et al, 90 2003 Cross-sectional Interrupted L anterior cingulate sulcus in CHR vs controls, but no differences between CHR-t and CHR-n Garner et al, 105 2005 Cross-sectional Larger baseline pituitary volume in CHR-t vs CHR-n Wood et al, 87 2005 Cross-sectional Smaller hippocampal volume and less L anterior cingulate folding in CHR with GHR vs CHR without GHR Velakoulis et al, 100 2006 Cross-sectional Normal baseline hippocampal and amygdala volume in CHR Smaller whole-brain volumes in CHR vs controls Fornito et al, 89 2008 Longitudinal Bilateral thinning of anterior cingulate in CHR-t also associated with negative symptoms Baseline anterior cingulate differences in CHR-t vs CHR-n predicted time to psychosis onset Takahashi et al, 99 2008 Cross-sectional No increased prevalence of cavum septi pellucidi enlargement in CHR Walterfang et al, 108 2008 Cross-sectional Smaller anterior corpus callosum in CHR-t vs CHR-n Sun et al, 103 2009 Longitudinal Greater brain contraction in R PFC in CHR-t vs CHR over time Takahashi et al, 94 2009 Longitudinal Smaller baseline insula bilaterally in CHR-t vs CHR-n, and in R insula vs controls Reduced GM of bilateral insula in CHR-t vs CHR-n and controls Hannan et al, 96 2010 Cross-sectional No differences in caudate volume in CHR at baseline vs controls or in CHR-t vs CHR-n Takahashi et al, 79 2010 Cross-sectional Smaller STG bilaterally at baseline in CHR vs controls Wood et al, 86 2010 Cross-sectional Smaller L hippocampal volume in CHR vs controls Dazzan et al, 81 2012 Longitudinal Smaller frontal cortex volume in CHR-t vs CHR-n at baseline Reduced parietal cortex and temporal cortex (trend) in CHR-t vs CHR-n Whitford et al, 95 2012 Cross-sectional Smaller cuneus in CHR-HSV-11 vs CHR-HSV-1– and controls Basel Borgwardt et al, 69 2007 Cross-sectional Smaller GM at baseline in posterior cingulate and precuneus bilaterally and L superior parietal lobule in CHR-t vs controls Borgwardt et al, 88 2007 Longitudinal Smaller L insula, STG, cingulate gyrus, and precuneus in CHR vs controls Reduced R insula, inferior frontal and STG in CHR-t vs CHR-n Borgwardt et al, 102 2008 Longitudinal Reduced orbitofrontal, superior frontal, inferior temporal, parietal cortex, and cerebellum in CHR-t vs controls over time Haller et al, 92 2009 Cross-sectional Whole-brain cortical thickness asymmetry in CHR vs controls Koutsouleris et al, 73 2009 Cross "
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    • "The vast majority of the studies have examined neuroanatomical alterations by measuring grey matter volume (GMV) using voxel-based morphometry (VBM) (Kubicki et al., 2002; Pantelis et al., 2003; Narr et al., 2005; Borgwardt et al., 2007b; Borgwardt et al., 2008; Meisenzahl et al., 2008; Witthaus et al., 2009; Mechelli et al., 2011); in addition, a smaller number of studies have measured cortical thickness(CT) using a cortical surface-based approach (Wiegand et al., 2004; Fornito et al., 2008; Schultz et al., 2010; Ziermans et al., 2010; Jung et al., 2011). With regard to patients in the early stages of psychosis, consistent GMV and CT alterations have been reported in medial and lateral temporal regions and, to a lesser extent, dorsolateral prefrontal and cingulate regions (Kubicki et al., 2002; Wiegand et al., 2004; Narr et al., 2005; Fornito et al., 2008; Witthaus et al., 2009; Schultz et al., 2010; Bodnar et al., 2011; Jung et al., 2011).With regard to individuals at high risk of developing the disorder, GVM and CT alterations have been reported in frontal, cingulate and temporal regions (Borgwardt et al., 2007b; Witthaus et al., 2009; Ziermans et al., 2010; Jung et al., 2011). "
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