title: A Comparative Study of Pituitary Volume Variations in MRI in Acute Onset of Psychiatric Conditions.
abstract: BACKGROUND
  The growing belief that endocrine abnormalities may underlie many mental conditions has led to increased use of imaging and hormonal assays in patients attending to psychiatric OPDs. People who are in an acute phase of a psychiatric disorder show Hypothalamic Pituitary Adrenal (HPA) axis hyperactivity, but the precise underlying central mechanisms are unclear.
  
  
  OBJECTIVE
  To assess the pituitary gland volume variations in patients presenting with new onset acute psychiatric illness in comparison with age and gender matched controls by using MRI.
  
  
  METHODS
  The study included 50 patients, with symptoms of acute psychiatric illness presenting within one month of onset of illness and 50 age and gender matched healthy controls. Both patients and controls were made to undergo MRI of the Brain. A 0.9 mm slices of entire brain were obtained by 3 dimensional T1 weighted sequence. Pituitary gland was traced in all sagittal slices. Anterior pituitary and posterior pituitary bright spot were measured separately in each slice. Volume of the pituitary (in cubic centimetre- cm3) was calculated by summing areas. Significance of variations in pituitary gland volumes was compared between the cases and controls using Analysis of Covariance (ANOVA).
  
  
  RESULTS
  There were significantly larger pituitary gland volumes in the cases than the controls, irrespective of psychiatric diagnosis (ANOVA, f=15.56; p=0.0002). Pituitary volumes in cases were 15.36% (0.73 cm3) higher than in controls.
  
  
  CONCLUSIONS
  There is a strong likelihood of HPA axis overactivity during initial phase of all mental disorders along with increased pituitary gland volumes. Further studies including hormonal assays and correlation with imaging are likely to provide further insight into neuroanatomical and pathological basis of psychiatric disorders.
authors.affiliation: Classified Specialist (Radiodiagnosis), Department of Radiology, Command Hospital Air Force , Bangalore, Karnataka, India .
authors.forename: Brijesh Kumar
authors.initials: BK
authors.lastname: Soni
authors.affiliation: Assistant Professor, Department of Radiology, JJM Medical College , Davangere, Bangalore, Karnataka, India .
authors.forename: Upendra Kumar
authors.initials: UK
authors.lastname: Joish
authors.affiliation: Air Officer Commanding, 5 Air Force Hospital , Jorhat, Assam, India .
authors.forename: Hirdesh
authors.initials: H
authors.lastname: Sahni
authors.affiliation: Head of Department and Senior Advisor (Radiodiagnosis), Department of Radiology, Command Hospital Air Force , Bangalore, Karnataka, India .
authors.forename: Raju A
authors.initials: RA
authors.lastname: George
authors.affiliation: Senior Advisor and Interventional Neuroradiologist, Department of Radiology, Command Hospital Air Force , Bangalore, Karnataka, India .
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sivasankar
authors.affiliation: Classified Specialist (Radiodiagnosis), Department of Radiology, Command Hospital Air Force , Bangalore, Karnataka, India .
authors.forename: Rohit
authors.initials: R
authors.lastname: Aggarwal
keywords: Acute psychiatric diseases; Hypothalamic-pituitary-adrenal axis; MR Volumetry; Pituitary gland