Human subcortical brain asymmetries in 15,847 people worldwide reveal effects of age and sex

The two hemispheres of the human brain differ functionally and structurally. Despite over a century of research, the extent to which brain asymmetry is influenced by sex, handedness, age, and genetic factors is still controversial. Here we present the largest ever analysis of subcortical brain asymmetries, in a harmonized multi-site study using meta-analysis methods. Volumetric asymmetry of seven subcortical structures was assessed in 15,847 MRI scans from 52 datasets worldwide. There were sex differences in the asymmetry of the globus pallidus and putamen. Heritability estimates, derived from 1170 subjects belonging to 71 extended pedigrees, revealed that additive genetic factors influenced the asymmetry of these two structures and that of the hippocampus and thalamus. Handedness had no detectable effect on subcortical asymmetries, even in this unprecedented sample size, but the asymmetry of the putamen varied with age. Genetic drivers of asymmetry in the hippocampus, thalamus and basal ganglia may affect variability in human cognition, including susceptibility to psychiatric disorders

Gestufte, evidenzbasierte, integrierte Versorgung

Deutschland ist wie viele andere Länder von der hohen und stetig steigenden gesundheitlichen und wirtschaftlichen Belastung durch psychische Erkrankungen betroffen. Im Jahr 2015, dem Referenzjahr der RECOVER-Studie, verursachten psychische Erkrankungen in Deutschland jährliche gesellschaftliche Kosten in Höhe von 146 Milliarden Euro, 4,8 % des Bruttoinlandsproduktes, Tendenz steigend. Davon waren 44,4 Milliarden Euro direkte Gesundheitskosten inklusive 24,9 Milliarden Euro Krankenhauskosten. Laut der Organisation für wirtschaftliche Zusammenarbeit (OECD) spielt hier vor allem die unzureichende Etablierung evidenzbasierter Versorgungsmodelle in Deutschland eine Rolle, vor allem für Menschen mit schweren psychischen Erkrankungen

Reduction of cerebellar grey matter in Crus I and II in schizophrenia

Structural deficiencies within the cerebellum have been associated with schizophrenia. Whereas several region-of-interest-based studies have shown deviations in cerebellar volume, meta-analyses on conventional whole-brain voxel-based morphometry (VBM) studies do not implicate abnormalities in the cerebellum. Since this discrepancy could be due to methodological problems of VBM, we used a cerebellum-optimized VBM procedure. We acquired high-resolution MRI scans from 29 schizophrenia patients and 45 healthy controls and used a VBM approach utilizing the Spatially Unbiased Infratentorial toolbox (Diedrichsen in Neuroimage 33:127-138, 2006). Relative to healthy controls, schizophrenia patients showed reductions of grey matter volume in the left cerebellum Crus I/II that were correlated with thought disorder (p < 0.05; one-sided) and performance in the Trail-making test B (p < 0.01). No cerebellar group differences were detected employing conventional whole-brain VBM. The results derived from the cerebellum analysis provide evidence for distinct grey matter deficits in schizophrenia located in Crus I/II. The association of this area with thought disorder and Trail-making performance supports the previously suggested role of the cerebellum in coordination of mental processes including disordered thought in schizophrenia. The failure of conventional VBM to detect such effects suggests that previous studies might have underestimated the importance of cerebellar structural deficits in schizophrenia

Altering the course of schizophrenia: progress and perspectives

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