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SEVERITY DEMONSTRATED BY MULTIMODAL MORPHOMETRY AND FUNCTIONAL MR IMAGING IN AUDITORY HALLUCINATIONS
Abstracts
Poster 119 SEVERITY DEMONSTRATED BY MULTIMODAL MORPHOMETRY AND FUNCTIONAL MR IMAGING IN AUDITORY HALLUCINATIONS Julio Sanjuan1, Eduardo J. Aguilar2, Gracian Garcia-Marti3, Luis Marti-Bonmati4, Maria de La Iglesia2 1 Faculty of Medicine CIBERSAM Valencia, Valencia, Spain; 2Sagunto Hospital. CIBERSAM Sagunto, Valencia, Spain; 3Quiron Hospital. CIBERSAM Valencia, Valencia, Spain; 4Peset Hospital Valencia, Valencia, Spain Background: The aim of this study was to validate a multimodal (structural and functional magnetic resonance) approach previously used to study auditory hallucinations. Coinciding clusters in brain areas known to be linked to auditory hallucinations are hypothesized to correlate with clinical severity. Methods: In total, 22 patients meeting DSM-IV criteria for schizophrenia and experiencing persistent hallucinations together with 28 healthy controls were evaluated with the same protocol, which consisted of an auditory paradigm designed to replicate those emotions related to the patients' hallucinatory experiences. Coincidence maps were obtained by combining structural maps of gray matter reduction with emotional functional activation. Results: The coincidence analysis showed areas with coexistence of gray matter reductions and emotional activation in the middle temporal gyrus (bilateral) and superior temporal gyrus (bilateral). Significant negative correlations between BPRS and PSYRATS scales were observed in schizophrenic patients. BPRS scores were negatively correlated in middle temporal gyrus (right), while negative PSYRATS correlation affected regions in both the superior temporal gyrus (left) and middle temporal gyrus (left). Discussion: Our data identify the left superior and middle temporal gyri as relevant areas for the study of auditory hallucinations. These results give support for the use of multimodal approaches, particularly a structural and functional magnetic resonance technique previously published by our group (Martí-Bonmatí et al., 2007) for identifying areas specifically linked to the pathogenesis of auditory hallucinations.
doi:10.1016/j.schres.2010.02.880
Poster 120 THE NEURAL CORRELATES OF SEVERE COGNITIVE IMPAIRMENT IN SCHIZOPHRENIA Peter John McKenna, Jordi Ortiz Gil, Edith Pomarol-Clotet, Raymond Salvador, Erick Jorge Canales-Rodríguez, Salvador Sarro Benito Menni CASM - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain Background: Cognitive impairment is an established finding in schizophrenia, and can be profound in some cases. Nevertheless, little is known about its relationship to the structural and functional brain abnormalities which also characterize the disorder. Methods: We carried out structural MRI and voxel-based morphometry (VBM) in 25 cognitively impaired and 18 cognitively preserved schizophrenic patients, and also 31 matched controls. Presence of cognitive impairment was defined on the basis of performance below the 1st percentile on either the Rivermead Behavioural Memory Test (RBMT) or the Behavioural Assessment of Dysexecutive Syndrome (BADS), or below the 5th percentile on both. A subset of 18 cognitively impaired patients, 15 cognitively preserved patients and 30 controls also underwent fMRI during performance of a working memory task. Results: No differences were found between cognitively intact and cognitively impaired patients in lateral ventricular volume or whole
469
brain volume. Voxel-based morphometry also failed to reveal clusters of significant difference in grey matter volume. However, during performance of the n-back task, the cognitively impaired patients showed hypoactivation compared to the cognitively intact patients in a large area that included the dorsolateral prefrontal cortex, the supplementary motor area, the precentral, postcentral and supramarginal gyri and the insula bilaterally. Discussion: Cognitively impaired schizophrenic patients show no more structural brain abnormality than in the disorder as a whole, but that their brain function is more compromised. This finding could have implications for cognitive remediation strategies in schizophrenia.
doi:10.1016/j.schres.2010.02.881
Poster 121 REDUCED CORTICAL THICKNESS IN FIRST EPISODE SCHIZOPHRENIA C. Chr. Schultz, Kathrin Koch, Gerd Wagner, Martin Roebel, Heinrich Sauer, Ralf G.M. Schlösser University of Jena Jena, Thüringen, Germany Background: Previous morphometric studies are suggesting altered cortical thickness mainly in prefronto – temporal regions in first episode schizophrenia. In an extension of these earlier studies, we used an entire cortex vertex wise approach and an automated clustering for the detection and exact quantification of cortical thickness alterations in first episode schizophrenia. Methods: A group of 54 patients with first-episode schizophrenia according to DSM IV and 54 age and gender matched healthy control subjects were included. All participants underwent highresolution T1- weighted MRIs scans on a 1.5 Tesla scanner. Cortical thickness was estimated as the distance between the gray-white matter border and the pial surface using an automated computerized algorithm (Freesurfer Software). Statistical cortical maps were created to estimate differences of cortical thickness between groups based on this entire cortex analysis. Results: Significant cortical thinning was observed in first-episode schizophrenia patients relative to controls in a number of cortical areas including the dorsolateral and frontopolar cortices, the anterior cingulate cortex, a ventrolateral-orbitofrontal cluster, as well as the superior temporal cortices and superior parietal lobe. Cortical thinning within these regions was on average 4.4-5.7% with strongest reductions in orbitofrontal regions (7.1%). Discussion: The present findings suggest widespread reduction of cortical thickness, mostly in heteromodal cortices of frontotemporal networks to be present at an early stage of schizophrenia. Taken together, the present morphometric data in first-episode schizophrenia provide further evidence for potential neurodevelopmental deficits and disruption of cortical maturation in this disorder. doi:10.1016/j.schres.2010.02.882
Poster 122 FUNCTIONAL MAGNETIC RESONANCE IMAGING OF INNER SPEECH IN SCHIZOPHRENIA
Sukhi S. Shergill1, Derek K. Tracy1, Kiran Sanghera1, Owen O'Daly1, James Gilleen1, Maria Dominguez2, Lydia Krabbendam1,2,3, Claudia Simons1,2 1 Institute of Psychiatry, Kings College London London United Kingdom;
Poster 119 SEVERITY DEMONSTRATED BY MULTIMODAL MORPHOMETRY AND FUNCTIONAL MR IMAGING IN AUDITORY HALLUCINATIONS Julio Sanjuan1, Eduardo J. Aguilar2, Gracian Garcia-Marti3, Luis Marti-Bonmati4, Maria de La Iglesia2 1 Faculty of Medicine CIBERSAM Valencia, Valencia, Spain; 2Sagunto Hospital. CIBERSAM Sagunto, Valencia, Spain; 3Quiron Hospital. CIBERSAM Valencia, Valencia, Spain; 4Peset Hospital Valencia, Valencia, Spain Background: The aim of this study was to validate a multimodal (structural and functional magnetic resonance) approach previously used to study auditory hallucinations. Coinciding clusters in brain areas known to be linked to auditory hallucinations are hypothesized to correlate with clinical severity. Methods: In total, 22 patients meeting DSM-IV criteria for schizophrenia and experiencing persistent hallucinations together with 28 healthy controls were evaluated with the same protocol, which consisted of an auditory paradigm designed to replicate those emotions related to the patients' hallucinatory experiences. Coincidence maps were obtained by combining structural maps of gray matter reduction with emotional functional activation. Results: The coincidence analysis showed areas with coexistence of gray matter reductions and emotional activation in the middle temporal gyrus (bilateral) and superior temporal gyrus (bilateral). Significant negative correlations between BPRS and PSYRATS scales were observed in schizophrenic patients. BPRS scores were negatively correlated in middle temporal gyrus (right), while negative PSYRATS correlation affected regions in both the superior temporal gyrus (left) and middle temporal gyrus (left). Discussion: Our data identify the left superior and middle temporal gyri as relevant areas for the study of auditory hallucinations. These results give support for the use of multimodal approaches, particularly a structural and functional magnetic resonance technique previously published by our group (Martí-Bonmatí et al., 2007) for identifying areas specifically linked to the pathogenesis of auditory hallucinations.
doi:10.1016/j.schres.2010.02.880
Poster 120 THE NEURAL CORRELATES OF SEVERE COGNITIVE IMPAIRMENT IN SCHIZOPHRENIA Peter John McKenna, Jordi Ortiz Gil, Edith Pomarol-Clotet, Raymond Salvador, Erick Jorge Canales-Rodríguez, Salvador Sarro Benito Menni CASM - CIBERSAM Sant Boi de Llobregat, Barcelona, Spain Background: Cognitive impairment is an established finding in schizophrenia, and can be profound in some cases. Nevertheless, little is known about its relationship to the structural and functional brain abnormalities which also characterize the disorder. Methods: We carried out structural MRI and voxel-based morphometry (VBM) in 25 cognitively impaired and 18 cognitively preserved schizophrenic patients, and also 31 matched controls. Presence of cognitive impairment was defined on the basis of performance below the 1st percentile on either the Rivermead Behavioural Memory Test (RBMT) or the Behavioural Assessment of Dysexecutive Syndrome (BADS), or below the 5th percentile on both. A subset of 18 cognitively impaired patients, 15 cognitively preserved patients and 30 controls also underwent fMRI during performance of a working memory task. Results: No differences were found between cognitively intact and cognitively impaired patients in lateral ventricular volume or whole
469
brain volume. Voxel-based morphometry also failed to reveal clusters of significant difference in grey matter volume. However, during performance of the n-back task, the cognitively impaired patients showed hypoactivation compared to the cognitively intact patients in a large area that included the dorsolateral prefrontal cortex, the supplementary motor area, the precentral, postcentral and supramarginal gyri and the insula bilaterally. Discussion: Cognitively impaired schizophrenic patients show no more structural brain abnormality than in the disorder as a whole, but that their brain function is more compromised. This finding could have implications for cognitive remediation strategies in schizophrenia.
doi:10.1016/j.schres.2010.02.881
Poster 121 REDUCED CORTICAL THICKNESS IN FIRST EPISODE SCHIZOPHRENIA C. Chr. Schultz, Kathrin Koch, Gerd Wagner, Martin Roebel, Heinrich Sauer, Ralf G.M. Schlösser University of Jena Jena, Thüringen, Germany Background: Previous morphometric studies are suggesting altered cortical thickness mainly in prefronto – temporal regions in first episode schizophrenia. In an extension of these earlier studies, we used an entire cortex vertex wise approach and an automated clustering for the detection and exact quantification of cortical thickness alterations in first episode schizophrenia. Methods: A group of 54 patients with first-episode schizophrenia according to DSM IV and 54 age and gender matched healthy control subjects were included. All participants underwent highresolution T1- weighted MRIs scans on a 1.5 Tesla scanner. Cortical thickness was estimated as the distance between the gray-white matter border and the pial surface using an automated computerized algorithm (Freesurfer Software). Statistical cortical maps were created to estimate differences of cortical thickness between groups based on this entire cortex analysis. Results: Significant cortical thinning was observed in first-episode schizophrenia patients relative to controls in a number of cortical areas including the dorsolateral and frontopolar cortices, the anterior cingulate cortex, a ventrolateral-orbitofrontal cluster, as well as the superior temporal cortices and superior parietal lobe. Cortical thinning within these regions was on average 4.4-5.7% with strongest reductions in orbitofrontal regions (7.1%). Discussion: The present findings suggest widespread reduction of cortical thickness, mostly in heteromodal cortices of frontotemporal networks to be present at an early stage of schizophrenia. Taken together, the present morphometric data in first-episode schizophrenia provide further evidence for potential neurodevelopmental deficits and disruption of cortical maturation in this disorder. doi:10.1016/j.schres.2010.02.882
Poster 122 FUNCTIONAL MAGNETIC RESONANCE IMAGING OF INNER SPEECH IN SCHIZOPHRENIA
Sukhi S. Shergill1, Derek K. Tracy1, Kiran Sanghera1, Owen O'Daly1, James Gilleen1, Maria Dominguez2, Lydia Krabbendam1,2,3, Claudia Simons1,2 1 Institute of Psychiatry, Kings College London London United Kingdom;