title: Adverse childhood experiences influence the detrimental effect of bipolar disorder and schizophrenia on cortico-limbic grey matter volumes.
abstract: BACKGROUND
  Adverse childhood experiences (ACE) can lead to several negative consequences in adult life, are highly prevalent in psychiatric disorders where they associate with clinical and brain morphological features. Grey matter volume loss is a central characteristic of bipolar disorder (BD) and schizophrenia (SCZ). The aim of this study is to measure the effect of diagnosis and ACE on GM volume in a sample of patients with BD or SCZ compared with healthy controls (HC).
  
  
  METHODS
  We studied 206 depressed BD patients, 96 SCZ patients and 136 healthy subjects. GM volumes were estimated with 3.0 Tesla MRI and analyzed with VBM technique. The effect of diagnosis was investigated in the whole sample and separately exposed to high and low ACE subjects.
  
  
  RESULTS
  An effect of diagnosis was observed in orbitofrontal cortex encompassing BA 47 and insula, and in the thalamus. HC had the highest volume and SCZ patients the lowest with BD patients showing an intermediate volume. This pattern persisted only in subjects with high ACE. No differences were observed for low ACE subjects.
  
  
  CONCLUSIONS
  The three diagnostic groups differ for age and education, previous and current medications, and treatment periods.
  
  
  CONCLUSIONS
  Our results underline the importance of ACE on the neural underpinnings of psychiatric psychopathology and suggest a major role of exposure to ACE for the GM deficits to reveal in clinical populations. Exposure to early stress is a crucial factor that must be taken in to account when searching for biomarkers of BD and SCZ.
authors.affiliation: Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy. Electronic address: poletti.sara@hsr.it.
authors.forename: Sara
authors.initials: S
authors.lastname: Poletti
authors.affiliation: Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Vai
authors.affiliation: Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Smeraldi
authors.affiliation: Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cavallaro
authors.affiliation: Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Colombo
authors.affiliation: Scientific Institute and University Vita-Salute San Raffaele, Department of Clinical Neurosciences, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Benedetti
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000473:pathology* / Q000523:psychology; D002540:Cerebral Cortex / Q000473:pathology*; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008016:Life Change Events; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000473:pathology*; D012565:Schizophrenic Psychology; D055815:Young Adult
keywords: Early stress; Grey matter; Insula; OFC; Thalamus