Effects of alcohol dependence comorbidity and antipsychotic medication on volumes of the thalamus and pons in schizophrenia.
OBJECTIVE
Postmortem and in vivo brain imaging studies have identified abnormalities in the thalamus and the pons in both schizophrenia and alcoholism. The authors sought to determine whether patients with both schizophrenia and alcohol dependence would manifest exaggerated volume deficits in either structure.


METHODS
Volumetric measures of the left and right thalamus and the pons were derived from magnetic resonance imaging scans obtained from 27 patients with schizophrenia, 19 patients with schizophrenia and comorbid alcohol dependence, 25 patients with alcohol dependence without comorbid axis I disorders, and 51 healthy comparison subjects.


RESULTS
The alcohol-dependent patients had significant volume deficits in both the thalamus and the pons. Among patients with schizophrenia, there were no differences in thalamus volumes between those with and without comorbid alcohol dependence. However, patients with schizophrenia who were taking atypical antipsychotic medications had bilateral thalamic deficits, whereas those taking typical neuroleptics did not. Patients with schizophrenia and comorbid alcohol dependence had deficits in the pons.


CONCLUSIONS
Patients with schizophrenia and comorbid alcohol dependence are at risk for alcohol-related reduction of pontine structures that are not necessarily affected by schizophrenia per se. The effect of alcohol dependence on the thalamus in schizophrenic patients may be mitigated by the type of neuroleptic medication they receive.
Sullivan
Edith V
EV
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5723, USA. edie@stanford.edu
Rosenbloom
Margaret J
MJ
Serventi
Kathleen L
KL
Deshmukh
Anjali
A
Pfefferbaum
Adolf
A
D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011149:Pons / Q000033:anatomy & histology* / Q000187:drug effects; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D013788:Thalamus / Q000033:anatomy & histology* / Q000187:drug effects
D014150:Antipsychotic Agents