The Association Between Familial Risk and Brain Abnormalities Is Disease Specific: An ENIGMA-Relatives Study of Schizophrenia and Bipolar Disorder

Background: Schizophrenia and bipolar disorder share genetic liability, and some structural brain abnormalities are common to both conditions. First-degree relatives of patients with schizophrenia (FDRs-SZ) show similar brain abnormalities to patients, albeit with smaller effect sizes. Imaging findings in first-degree relatives of patients with bipolar disorder (FDRs-BD) have been inconsistent in the past, but recent studies report regionally greater volumes compared with control subjects. Methods: We performed a meta-analysis of global and subcortical brain measures of 6008 individuals (1228 FDRs-SZ, 852 FDRs-BD, 2246 control subjects, 1016 patients with schizophrenia, 666 patients with bipolar disorder) from 34 schizophrenia and/or bipolar disorder family cohorts with standardized methods. Analyses were repeated with a correction for intracranial volume (ICV) and for the presence of any psychopathology in the relatives and control subjects. Results: FDRs-BD had significantly larger ICV (d = +0.16, q <.05 corrected), whereas FDRs-SZ showed smaller thalamic volumes than control subjects (d = −0.12, q <.05 corrected). ICV explained the enlargements in the brain measures in FDRs-BD. In FDRs-SZ, after correction for ICV, total brain, cortical gray matter, cerebral white matter, cerebellar gray and white matter, and thalamus volumes were significantly smaller; the cortex was thinner (d < −0.09, q <.05 corrected); and third ventricle was larger (d = +0.15, q <.05 corrected). The findings were not explained by psychopathology in the relatives or control subjects. Conclusions: Despite shared genetic liability, FDRs-SZ and FDRs-BD show a differential pattern of structural brain abnormalities, specifically a divergent effect in ICV. This may imply that the neurodevelopmental trajectories leading to brain anomalies in schizophrenia or bipolar disorder are distinct

Relationship Between Serum Agouti-Related Peptide Levels and Metabolic Syndrome in Euthymic Bipolar Patients

Introduction: Agouti-Related Peptide (AgRP) is expressed primarily in the hypothalamic arcuate nucleus, stimulates appetite and decreases metabolism and energy expenditure. The aim of our study is to evaluate the relationship between serum Agouti-Related Peptide (AgRP) levels and metabolic syndrome in euthymic bipolar patients Methods: Forty euthymic bipolar patients who used only mood stabilizer for at least three months and 40 healthy volunteers as control group were included in the study. We measured fasting blood glucose levels and serum levels of AgRP, total cholesterol, triglyceride, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) of all participants. The main outcome measure was the difference between patients and control groups in terms of metabolic syndrome frequency and the relationship between serum AgRP level and metabolic syndrome is also investigated. Results: The metabolic syndrome was significantly more common in euthymic bipolar patients than in control group (p=0.039). Additionally, levels of blood glucose and triglyceride were significantly higher in the patient group than in the control group (p=0.006 and 0.01 respectively). Serum AgRP levels did not differ between the patient and control groups (p=0.35). Also, in euthymic bipolar patients, there was no significant difference in serum AgRP levels between patients with metabolic syndrome and those without (p=0.754). Conclusion: We found significantly higher frequency of metabolic syndrome in euthymic bipolar patients than in the control group. However, there was no significant difference in the levels of serum AgRP between bipolar patients with and without metabolic syndrome in either study groups.This study was supported financially from Scientific Research Project (BAP Proje no: 2016-TIP-034) of Ege University Medical School.Scientific Research Project (BAP Proje) of Ege University Medical School [2016-TIP-034

Personality change after ‘flow diverter implantation’ for intracranial aneurysm in a patient with stroke: A case report

Objective: This study aimed to present a patient with psychiatric symptoms that occur after flow diverter stent placement in a posterior communicating artery (PComA) aneurysm in a patient. Design: A case study. Method: We performed cranial magnetic resonance imaging (MRI), magnetic resonance angiography, computed tomography angiography, neuropsychological tests, Levenson Self-Report Psychopathy Scale (LSRP), and a 25-item version of the Wender Utah Rating Scale (WURS-25). The patient’s recent MRI was compared with previous MRIs. Neuropsychological testing consisted of a clinical interview, clinical assessment of frontal lobe syndrome, and tests evaluating the prefrontal cortex functions (Wisconsin Card Sorting Test-128 card version and Iowa Gambling Test). Results: Our results showed that the patient’s personality change and psychiatric symptoms occurred after the stent placement. Symptoms were still present at evaluation two and a half years after stent placement. Conclusion: The study demonstrates personality changes and psychiatric symptoms that might occur as complications following the placement of a flow diverter for incidentally detected aneurysm

Small Frontal Gray Matter Volume in First-Episode Depression Patients

WOS: 000281709900001PubMed ID: 20818506Objective: Brain imaging studies have shown that depressed individuals suffer from inadequate frontal lobefunctions vis a vis smaller frontal lobes. The effects of depression's recurrent nature and long-term antidepressant treatment are not definitely known. This study aimed to examine frontal lobe volume at the onset of clinical depression by including first-episode drug-naive depressed patients. Method: The study included 23 first-episode drug-free major depression patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and 28 healthy age- and sex-matched controls. Cranial magnetic resonance (MR) images were obtained in both groups using a 1.5 Tesla device. Gray and white matter volumes in the frontal lobes were measured using the Medical Image Processing Analysis and Visualization (MIPAV) computer program. Results: Frontal gray matter volume in the patients was lower than that in the control group. White matter and total intracranial volume did not differ between the 2 groups. Small gray matter volume was not correlated with the duration or severity of illness. Conclusion: The results of this study indicate that frontal lobe gray matter volume is low in first-episode depressed patients and is independent of both illness severity and duration. This result suggests that the observed changes in the frontal lobe could have occurred before the clinical symptoms of depression were observed

Gray Matter Changes in Patients with Deficit Schizophrenia and Non-Deficit Schizophrenia

WOS: 000312607300004PubMed ID: 23225124Gray Matter Changes in Patients with Deficit Schizophrenia and Non-Deficit Schizophrenia Objectives: Reduced gray matter volume is a frequently reported Finding in brain imaging studies performed with schizophrenia patients. Some studies suggest a probable link between the negative symptoms of schizophrenia and gray matter loss; however, some of the negative symptoms observed in schizophrenia patients are not primarily linked to the core of schizophrenia. This study aimed to compare gray matter volumes in patients with primary negative symptoms (deficit schizophrenia [DS]), non-DS (NDS) patients, and healthy controls. Materials and Methods: The study included 11 DS patients, 18 non-DS patients, and 17 healthy controls. Magnetic resonance imaging (MRI) was performed using a 1.5 Tesla MR unit. The Schedule for Deficit Syndrome (SDS) was used to determine which patients were DS and non-DS. MR images were compared using voxel-based morphometry (VBM) analysis. Results: Contrary to expectations, no evidence to support less gray matter in DS patients than in NDS patients was observed. Furthermore, NDS patients had less gray matter volume in several brain regions (frontal and temporal cortices) than did the DS patients. All patients had perisylvian gray matter volume deficits, though the NDS patients had more widespread volume deficiencies. Conclusion: No evidence to support the hypothesis that DS patients have less gray matter volume than those of NDS patients was observed. On the contrary, DS patients had more gray matter volume in some regions; the differences observed in gray matter volume in these brain regions between the 2 patient groups may be responsible for the differences in their clinical manifestations

The effects of sexual abuse on female adolescent brain structures

Sexual abuse (SA) is known for its effects on brain structures in adolescents. We aimed to explore if SA has any effect on limbic and prefrontal cortex (PFC) structures. We hypothesized that children with SA would have a thinner PFC with larger amygdala and hippocampus that lead to aberrations in threat detection, orientation and response circuit; that would be highly adaptive in a dangerous environment in the short term

Gradual Loss of Social Group Support during Competition Activates Anterior TPJ and Insula but Deactivates Default Mode Network

Group forming behaviors are common in many species to overcome environmental challenges. In humans, bonding, trust, group norms, and a shared past increase consolidation of social groups. Being a part of a social group increases resilience to mental stress; conversely, its loss increases vulnerability to depression. However, our knowledge on how social group support affects brain functions is limited. This study observed that default mode network (DMN) activity reduced with the loss of social group support from real-life friends in a challenging social competition. The loss of support induced anterior temporoparietal activity followed by anterior insula and the dorsal attentional network activity. Being a part of a social group and having support provides an environment for high cognitive functioning of the DMN, while the loss of group support acts as a threat signal and activates the anterior temporoparietal junction (TPJ) and insula regions of salience and attentional networks for individual survival

ENIGMA-Relatives - Brain Volumes in First-Degree Relatives of Schizophrenia and Bipolar Patients

72nd Annual Scientific Convention and Meeting of the Society-of-Biological-Psychiatry (SOBP) -- MAY 18-20, 2017 -- San Diego, CAWOS: 000400348700279Soc Biol Psychia

Intelligence, educational attainment, and brain structure in those at familial high-risk for schizophrenia or bipolar disorder Hum Brain Mapp

First-degree relatives of patients diagnosed with schizophrenia (SZ-FDRs) show similar patterns of brain abnormalities and cognitive alterations to patients, albeit with smaller effect sizes. First-degree relatives of patients diagnosed with bipolar disorder (BD-FDRs) show divergent patterns; on average, intracranial volume is larger compared to controls, and findings on cognitive alterations in BD-FDRs are inconsistent. Here, we performed a meta-analysis of global and regional brain measures (cortical and subcortical), current IQ, and educational attainment in 5,795 individuals (1,103 SZ-FDRs, 867 BD-FDRs, 2,190 controls, 942 schizophrenia patients, 693 bipolar patients) from 36 schizophrenia and/or bipolar disorder family cohorts, with standardized methods. Compared to controls, SZ-FDRs showed a pattern of widespread thinner cortex, while BD-FDRs had widespread larger cortical surface area. IQ was lower in SZ-FDRs (d = -0.42, p = 3 × 10-5 ), with weak evidence of IQ reductions among BD-FDRs (d = -0.23, p = .045). Both relative groups had similar educational attainment compared to controls. When adjusting for IQ or educational attainment, the group-effects on brain measures changed, albeit modestly. Changes were in the expected direction, with less pronounced brain abnormalities in SZ-FDRs and more pronounced effects in BD-FDRs. To conclude, SZ-FDRs and BD-FDRs show a differential pattern of structural brain abnormalities. In contrast, both had lower IQ scores and similar school achievements compared to controls. Given that brain differences between SZ-FDRs and BD-FDRs remain after adjusting for IQ or educational attainment, we suggest that differential brain developmental processes underlying predisposition for schizophrenia or bipolar disorder are likely independent of general cognitive impairment

Intelligence, educational attainment, and brain structure in those at familial high-risk for schizophrenia or bipolar disorder

First‐degree relatives of patients diagnosed with schizophrenia (SZ‐FDRs) show similar patterns of brain abnormalities and cognitive alterations to patients, albeit with smaller effect sizes. First‐degree relatives of patients diagnosed with bipolar disorder (BD‐FDRs) show divergent patterns; on average, intracranial volume is larger compared to controls, and findings on cognitive alterations in BD‐FDRs are inconsistent. Here, we performed a meta‐analysis of global and regional brain measures (cortical and subcortical), current IQ, and educational attainment in 5,795 individuals (1,103 SZ‐FDRs, 867 BD‐FDRs, 2,190 controls, 942 schizophrenia patients, 693 bipolar patients) from 36 schizophrenia and/or bipolar disorder family cohorts, with standardized methods. Compared to controls, SZ‐FDRs showed a pattern of widespread thinner cortex, while BD‐FDRs had widespread larger cortical surface area. IQ was lower in SZ‐FDRs (d = −0.42, p = 3 × 10−5), with weak evidence of IQ reductions among BD‐FDRs (d = −0.23, p = .045). Both relative groups had similar educational attainment compared to controls. When adjusting for IQ or educational attainment, the group‐effects on brain measures changed, albeit modestly. Changes were in the expected direction, with less pronounced brain abnormalities in SZ‐FDRs and more pronounced effects in BD‐FDRs. To conclude, SZ‐FDRs and BD‐FDRs show a differential pattern of structural brain abnormalities. In contrast, both had lower IQ scores and similar school achievements compared to controls. Given that brain differences between SZ‐FDRs and BD‐FDRs remain after adjusting for IQ or educational attainment, we suggest that differential brain developmental processes underlying predisposition for schizophrenia or bipolar disorder are likely independent of general cognitive impairment