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WHITE MATTER TRACTS AS PREDICTORS OF TREATMENT OUTCOME
Abstracts
Results: Pro/Arg heterozygous for the Pro72Arg polymorphism showed a generalized deficit in whole-brain WM as compared to Pro/Pro homozygous (Mann-Whitney U = 22, z = -2.006, p = 0.045). This WM deficit was especially prominent in right frontal lobe (Mann-Whitney U = 16, z = -2.469, p = 0.012). Pro72Arg subjects showed decreased NAA/Co ratio levels in right DLPFC (Mann-Whitney U = 4, z = -2.038, p = 0.042). Discussion: TP53 genetic variability influences WM volumes in frontal lobes and NAA/Co ratio in DLPFC. Whether this effect arises from apoptotic processes or from an altered myelination as a consequence of a disturbed oligodendrocyte development warrants further research. Acknowledgements: Supported by Fundació "La Caixa" (99-111-00; 99-042-00), Instituto de Salud Carlos III, CIBER-Salud Mental (CIBERSAM) and Spanish Ministry of Science and Innovation (SAF2008-05674-C03-01). doi:10.1016/j.schres.2010.02.855
Poster 95 WHITE MATTER TRACTS AS PREDICTORS OF TREATMENT OUTCOME Tiago Reis Marques, Heather Taylor, Andy Simmons, Flavio Dell'Acqua, Robin Murray, Paula Dazzan Psychosis Clinical Academic Group - Institute of Psychiatry London, London, Portugal Background: The caudate volume is a structure often implicated in the pathogenesis of schizophrenia. This structure also regulates a number of cognitive functions. However, only few studies have investigated the correlation of cognitive functioning with caudate volume in patients with psychosis. To investigate caudate volume in first episode psychosis patients and healthy controls and to examine the relationship between caudate volume and cognitive functioning. Methods: 95 first episode psychosis patients (60 males, 35 females; mean age (27.49) ± 7.8; 47 schizophrenia, 29 Affective disorders, 18 Other) and 91 healthy controls (54 Males, 37 females; mean age (30.2) ± 8.72) were scanned using a 1.5 Tesla scanner. Caudate volume was estimated with the software MEASURE. Executive functioning, verbal memory, general intellectual ability and IQ were examined. Analyses of (Co)variance (ANCOVA) were conducted with age and whole brain volume as covariate's on the caudate volume, diagnosis and pharmacological data. Caudate volume was then correlated with neuropsychological scores. Results: Patients had larger caudate volume than healthy controls, albeit only at trend level (p = 0.069). Within the patient group, there was a positive correlation between caudate volume and performance on the Ravens task (p = 0.008) and the trail making task (p = 0.006). Discussion: These data suggest that a smaller caudate volume in schizophrenia is associated with a poorer performance in tests of general intellectual ability and executive function. doi:10.1016/j.schres.2010.02.856
Poster 96 CORTICAL THICKNESS AND SUBCORTICAL VOLUMES IN SCHIZOPHRENIA AND BIPOLAR DISORDER
Lars M. Rimol1, Cecilie Hartberg1, Ragnar Nesvåg1,2, Christine Fennema-Notestine4,5, Don Hagler Jr.5, Chris J. Pung5,
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Robin G. Jennings5, Unn K. Haukvik1, Elisabeth Lange1,2, Per H. Nakstad6, Ingrid Melle1,7, Ole A. Andreassen1,7, Anders M. Dale3,5, Ingrid Agartz1,8 1 Department of Psychiatry, Section Vinderen, University of Oslo Oslo, Oslo, Norway; 2Department of Psychiatry, Diakonhjemmet Hospital Oslo, Oslo, Norway; 3Department of Neurosciences, University of California San Diego La Jolla, CA, USA; 4Department of Psychiatry, University of California San Diego La Jolla, CA, USA; 5Department of Radiology, University of California San Diego La Jolla, CA, USA; 6 Department of Neuroradiology, Division of Radiology, Oslo University Hospital, University of Oslo Oslo, Oslo, Norway; 7Division of Psychiatry, Oslo University Hospital - Ulleval Oslo, Oslo, Norway; 8Department of Research and Development, Diakonhjemmet Hospital Oslo, Oslo, Norway Background: Schizophrenia and bipolar disorder are severe psychiatric diseases with partly overlapping symptomatology. Widespread brain morphological abnormalities, including cortical thinning and subcortical volume reductions, have been demonstrated in schizophrenia but it is unclear whether similar abnormalities are present in bipolar disorder. The purpose of this study was to compare cortical thickness and subcortical volumes in schizophrenia and bipolar disorder, in order to assess differences and similarities in cortical and subcortical brain structure. Methods: We analyzed MRI images from a sample of 173 patients with schizophrenia spectrum disorder, 139 patients with bipolar disorder (type 1 and 2), and 207 healthy control subjects. Cortical thickness was compared between the groups in multiple locations across the continuous cortical surface. Subcortical volumes were compared on a structure-by-structure basis. Results: Both patient groups showed substantial subcortical volume reductions bilaterally in the hippocampus, in the left thalamus, right nucleus accumbens, left cerebellar cortex, and the brainstem, along with substantial ventricular enlargements. There was no significant difference between schizophrenia and bipolar disorder in these structures; however, the effect sizes were consistently larger in the schizophrenia group. In the cortex, there was widespread, bilateral thinning in schizophrenia compared to healthy controls, in frontal, temporal, and occipital regions. There were a few, comparatively small, right hemisphere regions where bipolar disorder showed cortical thinning compared to controls; one in the superior frontal gyrus, one in the entorhinal cortex, and one in the occipitotemporal junction. However, comparing the subgroup of patients with bipolar disorder 1 to healthy controls, there was substantial, bilateral cortical thinning in the superior frontal lobes. Although there was no significant difference between schizophrenia and bipolar disorder in the cortex, the effect sizes were consistently larger in the schizophrenia group. Discussion: The overlapping patterns of subcortical volume reduction are consistent with a common subcortical pathophysiology for bipolar disorder and schizophrenia. Cortically, there was a larger discrepancy between findings in the schizophrenia and bipolar disorder groups. Although direct comparisons between the groups failed to yield statistically significant results, the healthy controls vs. bipolar disorder comparisons did not yield any findings in the left hemisphere, and somewhat limited findings in the right hemisphere, suggesting that bipolar disorder falls between healthy controls and schizophrenia. This is consistent with the effect sizes in these groups. Bipolar disorder type 1 showed cortical thinning more similar to that seen in the schizophrenia group; however, in contrast to schizophrenia, the inferior frontal, lateral and medial occipital, and most of the temporal lobes were not significantly affected.
doi:10.1016/j.schres.2010.02.857
Results: Pro/Arg heterozygous for the Pro72Arg polymorphism showed a generalized deficit in whole-brain WM as compared to Pro/Pro homozygous (Mann-Whitney U = 22, z = -2.006, p = 0.045). This WM deficit was especially prominent in right frontal lobe (Mann-Whitney U = 16, z = -2.469, p = 0.012). Pro72Arg subjects showed decreased NAA/Co ratio levels in right DLPFC (Mann-Whitney U = 4, z = -2.038, p = 0.042). Discussion: TP53 genetic variability influences WM volumes in frontal lobes and NAA/Co ratio in DLPFC. Whether this effect arises from apoptotic processes or from an altered myelination as a consequence of a disturbed oligodendrocyte development warrants further research. Acknowledgements: Supported by Fundació "La Caixa" (99-111-00; 99-042-00), Instituto de Salud Carlos III, CIBER-Salud Mental (CIBERSAM) and Spanish Ministry of Science and Innovation (SAF2008-05674-C03-01). doi:10.1016/j.schres.2010.02.855
Poster 95 WHITE MATTER TRACTS AS PREDICTORS OF TREATMENT OUTCOME Tiago Reis Marques, Heather Taylor, Andy Simmons, Flavio Dell'Acqua, Robin Murray, Paula Dazzan Psychosis Clinical Academic Group - Institute of Psychiatry London, London, Portugal Background: The caudate volume is a structure often implicated in the pathogenesis of schizophrenia. This structure also regulates a number of cognitive functions. However, only few studies have investigated the correlation of cognitive functioning with caudate volume in patients with psychosis. To investigate caudate volume in first episode psychosis patients and healthy controls and to examine the relationship between caudate volume and cognitive functioning. Methods: 95 first episode psychosis patients (60 males, 35 females; mean age (27.49) ± 7.8; 47 schizophrenia, 29 Affective disorders, 18 Other) and 91 healthy controls (54 Males, 37 females; mean age (30.2) ± 8.72) were scanned using a 1.5 Tesla scanner. Caudate volume was estimated with the software MEASURE. Executive functioning, verbal memory, general intellectual ability and IQ were examined. Analyses of (Co)variance (ANCOVA) were conducted with age and whole brain volume as covariate's on the caudate volume, diagnosis and pharmacological data. Caudate volume was then correlated with neuropsychological scores. Results: Patients had larger caudate volume than healthy controls, albeit only at trend level (p = 0.069). Within the patient group, there was a positive correlation between caudate volume and performance on the Ravens task (p = 0.008) and the trail making task (p = 0.006). Discussion: These data suggest that a smaller caudate volume in schizophrenia is associated with a poorer performance in tests of general intellectual ability and executive function. doi:10.1016/j.schres.2010.02.856
Poster 96 CORTICAL THICKNESS AND SUBCORTICAL VOLUMES IN SCHIZOPHRENIA AND BIPOLAR DISORDER
Lars M. Rimol1, Cecilie Hartberg1, Ragnar Nesvåg1,2, Christine Fennema-Notestine4,5, Don Hagler Jr.5, Chris J. Pung5,
459
Robin G. Jennings5, Unn K. Haukvik1, Elisabeth Lange1,2, Per H. Nakstad6, Ingrid Melle1,7, Ole A. Andreassen1,7, Anders M. Dale3,5, Ingrid Agartz1,8 1 Department of Psychiatry, Section Vinderen, University of Oslo Oslo, Oslo, Norway; 2Department of Psychiatry, Diakonhjemmet Hospital Oslo, Oslo, Norway; 3Department of Neurosciences, University of California San Diego La Jolla, CA, USA; 4Department of Psychiatry, University of California San Diego La Jolla, CA, USA; 5Department of Radiology, University of California San Diego La Jolla, CA, USA; 6 Department of Neuroradiology, Division of Radiology, Oslo University Hospital, University of Oslo Oslo, Oslo, Norway; 7Division of Psychiatry, Oslo University Hospital - Ulleval Oslo, Oslo, Norway; 8Department of Research and Development, Diakonhjemmet Hospital Oslo, Oslo, Norway Background: Schizophrenia and bipolar disorder are severe psychiatric diseases with partly overlapping symptomatology. Widespread brain morphological abnormalities, including cortical thinning and subcortical volume reductions, have been demonstrated in schizophrenia but it is unclear whether similar abnormalities are present in bipolar disorder. The purpose of this study was to compare cortical thickness and subcortical volumes in schizophrenia and bipolar disorder, in order to assess differences and similarities in cortical and subcortical brain structure. Methods: We analyzed MRI images from a sample of 173 patients with schizophrenia spectrum disorder, 139 patients with bipolar disorder (type 1 and 2), and 207 healthy control subjects. Cortical thickness was compared between the groups in multiple locations across the continuous cortical surface. Subcortical volumes were compared on a structure-by-structure basis. Results: Both patient groups showed substantial subcortical volume reductions bilaterally in the hippocampus, in the left thalamus, right nucleus accumbens, left cerebellar cortex, and the brainstem, along with substantial ventricular enlargements. There was no significant difference between schizophrenia and bipolar disorder in these structures; however, the effect sizes were consistently larger in the schizophrenia group. In the cortex, there was widespread, bilateral thinning in schizophrenia compared to healthy controls, in frontal, temporal, and occipital regions. There were a few, comparatively small, right hemisphere regions where bipolar disorder showed cortical thinning compared to controls; one in the superior frontal gyrus, one in the entorhinal cortex, and one in the occipitotemporal junction. However, comparing the subgroup of patients with bipolar disorder 1 to healthy controls, there was substantial, bilateral cortical thinning in the superior frontal lobes. Although there was no significant difference between schizophrenia and bipolar disorder in the cortex, the effect sizes were consistently larger in the schizophrenia group. Discussion: The overlapping patterns of subcortical volume reduction are consistent with a common subcortical pathophysiology for bipolar disorder and schizophrenia. Cortically, there was a larger discrepancy between findings in the schizophrenia and bipolar disorder groups. Although direct comparisons between the groups failed to yield statistically significant results, the healthy controls vs. bipolar disorder comparisons did not yield any findings in the left hemisphere, and somewhat limited findings in the right hemisphere, suggesting that bipolar disorder falls between healthy controls and schizophrenia. This is consistent with the effect sizes in these groups. Bipolar disorder type 1 showed cortical thinning more similar to that seen in the schizophrenia group; however, in contrast to schizophrenia, the inferior frontal, lateral and medial occipital, and most of the temporal lobes were not significantly affected.
doi:10.1016/j.schres.2010.02.857