Differences and similarities in insular and temporal pole MRI gray matter volume abnormalities in first-episode schizophrenia and affective psychosis.
BACKGROUND
Whether psychoses associated with schizophrenia and affective disorder represent manifestations of different disorders or the same disorder is an important but unresolved question in psychiatry. Results of previous volumetric magnetic resonance imaging investigations indicate that gray matter volume reductions in neocortical regions may be specific to schizophrenia.


OBJECTIVE
To simultaneously evaluate multiple olfactocentric paralimbic regions, which play crucial roles in human emotion and motivation, in first-episode patients with schizophrenia and affective psychosis.


METHODS
A cross-sectional study using high-spatial resolution magnetic resonance imaging in patients with schizophrenia and affective psychosis at their first hospitalization.


METHODS
Inpatient units at a private psychiatric hospital.


METHODS
Fifty-three first-episode patients, 27 with schizophrenia and 26 with affective (mainly manic) psychosis, and 29 control subjects.


METHODS
Using high-spatial resolution magnetic resonance imaging, the gray matter volumes of 2 olfactocentric paralimbic regions of interest, the insular cortex and the temporal pole, were evaluated.


RESULTS
A bilateral volume reduction in insular cortex gray matter was specific to first-episode patients with schizophrenia. In contrast, both first-episode psychosis groups showed a volume reduction in left temporal pole gray matter and an absence of normal left-greater-than-right asymmetry. Region of interest correlations showed that only patients with schizophrenia lacked a positive correlation between left temporal pole and left anterior amygdala-hippocampal complex gray matter volumes, whereas both psychosis groups were similar in lacking normal positive correlations between left temporal pole and left anterior superior temporal gyrus gray matter volumes.


CONCLUSIONS
These partially different and partially similar patterns of structural abnormalities in olfactocentric paralimbic regions and their associated abnormalities in other temporolimbic regions may be important factors in the differential and common manifestations of the 2 psychoses.
Kasai
Kiyoto
K
Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston Veterans Affairs Healthcare System/Brockton Division, Harvard Medical School, 940 Belmont Street, Brockton, MA 02301, USA.
Shenton
Martha E
ME
Salisbury
Dean F
DF
Onitsuka
Toshiaki
T
Toner
Sarah K
SK
Yurgelun-Todd
Deborah
D
Kikinis
Ron
R
Jolesz
Ferenc A
FA
McCarley
Robert W
RW
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001284:Atrophy; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D010054:Brief Psychiatric Rating Scale; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000473:pathology; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008032:Limbic System / Q000002:abnormalities / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008432:Mathematical Computing; D008609:Mental Status Schedule; D009415:Nerve Net / Q000002:abnormalities / Q000473:pathology; D009833:Olfactory Pathways / Q000002:abnormalities / Q000473:pathology; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D013702:Temporal Lobe / Q000002:abnormalities* / Q000473:pathology; D014888:Wechsler Scales