Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-25T06:35:17.330Z Has data issue: false hasContentIssue false
  • English
  • Français

Associations between brain morphology and outcome in schizophrenia in a general population sample

Published online by Cambridge University Press:  15 April 2020

E. Jääskeläinen ,
P. Juola ,
J. Kurtti ,
M. Haapea ,
M. Kyllönen ,
J. Miettunen ,
P. Tanskanen ,
G.K. Murray ,
S. Huhtaniska  and
A. Barnes
...Show all authors
E. Jääskeläinen*
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland Department of Psychiatry, Oulu University Hospital, P.O.BOX 26, 90029Oulu, Finland
P. Juola
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland
J. Kurtti
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland
M. Haapea
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland Department of Diagnostic Radiology, Oulu University Hospital, P.O. BOX 50, 90029OYS, Finland
M. Kyllönen
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland
J. Miettunen
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland Department of Psychiatry, Oulu University Hospital, P.O.BOX 26, 90029Oulu, Finland University of Oulu, Institute of Health Sciences, P.O. BOX 5000, 90014, Oulu, Finland
P. Tanskanen
Affiliation:
Department of Diagnostic Radiology, Oulu University Hospital, P.O. BOX 50, 90029OYS, Finland
G.K. Murray
Affiliation:
University of Cambridge, Department of Psychiatry, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
S. Huhtaniska
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland
A. Barnes
Affiliation:
University of Cambridge, Department of Psychiatry, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK Institute Of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, 235, Euston Road, London NW1 2BU, UK
J. Veijola
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland Department of Psychiatry, Oulu University Hospital, P.O.BOX 26, 90029Oulu, Finland
M. Isohanni
Affiliation:
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland Department of Psychiatry, Oulu University Hospital, P.O.BOX 26, 90029Oulu, Finland
*
*Corresponding author. University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014 Oulu, Finland. Tel.: +358 40 7474376. E-mail address: erika.jaaskelainen@oulu.fi (E. Jääskeläinen).
Get access

Abstract

Objective

To analyse associations between brain morphology and longitudinal and cross-sectional measures of outcomes in schizophrenia in a general population sample.

Methods

The sample was the Northern Finland 1966 Birth Cohort. In 1999–2001, structural brain MRI and measures of clinical and functional outcomes were analysed for 54 individuals with schizophrenia around the age of 34. Sex, total grey matter, duration of illness and the use of antipsychotic medication were used as covariates.

Results

After controlling for multiple covariates, increased density of the left limbic area was associated with less hospitalisations and increased total white matter volume with being in remission. Higher density of left frontal grey matter was associated with not being on a disability pension and higher density of the left frontal lobe and left limbic area were related to better functioning. Higher density of the left limbic area was associated with better longitudinal course of illness.

Conclusions

This study, based on unselected general population data, long follow-up and an extensive database, confirms findings of previous studies, that morphological abnormalities in several brain structures are associated with outcome. The difference in brain morphology in patients with good and poor outcomes may reflect separable aetiologies and developmental trajectories in schizophrenia.

Keywords

SchizophreniaPsychosisPrognosisBrainMRIOutcome
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 7 , September 2014 , pp. 456 - 462
Copyright
Copyright © 2013 Elsevier Masson SAS

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Tel.: +358 8 315 6910.

2

Tel.: +358 8 315 6923.

3

Tel.: +358 8 315 2011.

4

Tel.: +44 1223 764 678.

5

Fax: +44 1223 336 581.

References

Andreasen, N.C., Carpenter, W.T. Jr., Kane, J.M., Lasser, R.A., Marder, S.R., Weinberger, D.R.Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005;162(3):441–449.CrossRefGoogle ScholarPubMed
Andreasen, N.C., Nopoulos, P., Magnotta, V., Pierson, R., Ziebell, S., Ho, B.C.Progressive brain change in schizophrenia: a prospective longitudinal study of first-episode schizophrenia. Biol Psychiatry 2011;70:672–679.CrossRefGoogle ScholarPubMed
Bodnar, M., Malla, A.K., Czechowska, Y., Benoit, A., Fathalli, F., Joober, R.et al.Neural markers of remission in first-episode schizophrenia: a volumetric neuroimaging study of the hippocampus and amygdala. Schizophr Res 2010;122(1–3):72–80.CrossRefGoogle ScholarPubMed
Brammer, M.J., Bullmore, E.T., Simmons, A., Williams, S.C., Grasby, P.M., Howard, R.J.et al.Generic brain activation mapping in functional magnetic resonance imaging: a nonparametric approach. Magn Reson Imaging 1997;15(7):763–770.CrossRefGoogle ScholarPubMed
Brickman, A.M., Buchsbaum, M.S., Shihabuddin, L., Byne, W., Newmark, R.E., Brand, J.et al.Thalamus size and outcome in schizophrenia. Schizophr Res 2004;71(2–3):473–484.CrossRefGoogle Scholar
Buchsbaum, M.S., Shihabuddin, L., Brickman, A.M., Miozzo, R., Prikryl, R., Shaw, R.et al.Caudate and putamen volumes in good and poor outcome patients with schizophrenia. Schizophr Res 2003;64(1):53–62.CrossRefGoogle ScholarPubMed
García-Martí, G., Aguilar, E.J., Lull, J.J., Martí-Bonmatí, L., Escartí, M.J., Manjón, J.V.et al.Schizophrenia with auditory hallucinations: A voxel-based morphometry study. Prog Neuropsychopharmacol Biol Psychiatry 2008;32(1):72–80.CrossRefGoogle ScholarPubMed
Ha, T.H., Youn, T., Ha, K.S., Rho, K.S., Lee, J.M., Kim, I.Y.et al.Gray matter abnormalities in paranoid schizophrenia and their clinical correlations. Psychiatry Res Neuroimaging 2004;132(3):251–260.CrossRefGoogle ScholarPubMed
Haapea, M., Miettunen, J., Veijola, J., Lauronen, E., Tanskanen, P., Isohanni, M.Non-participation may bias the results of a psychiatric survey: an analysis from the survey including magnetic resonance imaging within the Northern Finland 1966 Birth Cohort. Soc Psychiatry Psychiatr Epidemiol 2007;42(5):403–409.CrossRefGoogle ScholarPubMed
Ho, B.C., Andreasen, N.C., Nopoulos, P., Arndt, S., Magnotta, V., Flaum, M.Progressive structural brain abnormalities and their relationship to clinical outcome. A longitudinal magnetic resonance imaging study early in schizophrenia. Arch Gen Psychiatry 2003;60:585–594.CrossRefGoogle Scholar
Ho, B.C., Andreasen, N.C., Ziebell, S., Pierson, R., Magnotta, V.Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry 2011;68(2):128–137.CrossRefGoogle ScholarPubMed
Hulshoff Pol, H.E., Schnack, H.G., Mandl, R.C.W., Cahn, W., Collins, D.L., Evans, A.C.et al.Focal white matter density changes in schizophrenia: reduced inter-hemispheric connectivity. Neuroimage 2004;21(1):27–35.CrossRefGoogle ScholarPubMed
Isohanni, M., Makikyro, T., Moring, J., Rasanen, P., Hakko, H., Partanen, U.et al.A comparison of clinical and research DSM-III-R diagnoses of schizophrenia in a Finnish national birth cohort. Clinical and research diagnoses of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 1997;32(5):303–308.CrossRefGoogle Scholar
Jenkinson, M., Smith, S.A global optimisation method for robust affine registration of brain images. Med Image Anal 2001;5(2):143–156.CrossRefGoogle ScholarPubMed
Kasparek, T., Prikryl, R., Schwarz, D., Kucerova, H., Marecek, R., Mikl, M.et al.Grey matter morphology and the level of functioning in one-year follow-up of first-episode schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2009;33(8):1438–1446.CrossRefGoogle ScholarPubMed
Kay, S.R., Opler, L.A., Fiszbein, A.Positive and Negative Syndrome Scale (PANSS). In: Rush, A.J. editors. Handbook of Psychiatric Measures Washington: American Psychiatric Association; 2000.Google Scholar
Lauronen, E., Miettunen, J., Veijola, J., Karhu, M., Jones, P.B., Isohanni, M.Outcome and its predictors in schizophrenia within the Northern Finland 1966 Birth Cohort. Eur Psychiatry 2007;22(2):2000. p. 129–136.CrossRefGoogle ScholarPubMed
Lawrie, S.M., McIntosh, A.M., Hall, J., Owens, D.G., Johnstone, E.C.Brain structure and function changes during the development of schizophrenia: the evidence from studies of subjects at increased genetic risk. Schizophr Bull 2008;34(2):330–340.CrossRefGoogle ScholarPubMed
Lui, S., Deng, W., Huang, X., Jiang, L., Ma, X., Chen, H.et al.Association of cerebral deficits with clinical symptoms in antipsychotic-naive first-episode schizophrenia: an optimized voxel-based morphometry and resting state functional connectivity study. Am J Psychiatry 2009;166(2):196–205.CrossRefGoogle ScholarPubMed
Miettunen, J., Lauronen, E., Veijola, J., Koponen, H., Saarento, O., Taanila, A.et al.Socio-demographic and clinical predictors of occupational status in schizophrenic psychoses – follow-up within the Northern Finland 1966 Birth Cohort. Psychiatry Res 2007;150(3):217–225.CrossRefGoogle ScholarPubMed
Miettunen, J., Suvisaari, J., Haukka, J., Isohanni, M.Use of register data for psychiatric epidemiology in the Nordic countries. In: Tsuang, M.Tohen, M.Jones, PTextbook in Psychiatric Epidemiology 3rd ed.Washington: Wiley-Blackwell; 2011. p. 117–131.CrossRefGoogle Scholar
Milev, P., Ho, B.C., Arndt, S., Nopoulos, P., Andreasen, N.C.Initial magnetic resonance imaging volumetric brain measurements and outcome in schizophrenia: a prospective longitudinal study with 5-year follow-up. Biol Psychiatry 2003;54(6):608–615.CrossRefGoogle ScholarPubMed
Mitelman, S.A., Shihabuddin, L., Brickman, A.M., Hazlett, E.A., Buchsbaum, M.S.MRI assessment of grey and white matter distribution in Brodmann's areas of the cortex in patients with schizophrenia with good and poor outcomes. Am J Psychiatry 2003;160(12):2154–2168.CrossRefGoogle Scholar
Mitelman, S.A., Shihabuddin, L., Brickman, A.M., Hazlett, E.A., Buchsbaum, M.S.Volume of the cingulate and outcome in schizophrenia. Schizophr Res 2005;72(2–3):91–108.CrossRefGoogle Scholar
Mitelman, S.A., Brickman, A.M., Shihabuddin, L., Newmark, R.E., Hazlett, E.A., Haznedar, M.M.et al.A comprehensive assessment of grey and white matter volumes and their relationship to outcome and severity in schizophrenia. Neuroimage 2007;37(2):449–462.CrossRefGoogle Scholar
Moilanen, K., Veijola, J., Laksy, K., Makikyro, T., Miettunen, J., Kantojarvi, L.et al.Reasons for the diagnostic discordance between clinicians and researchers in schizophrenia in the Northern Finland 1966 Birth Cohort. Soc Psychiatry Psychiatr Epidemiol 2003;38(6):305–310.CrossRefGoogle ScholarPubMed
Molina, V., Hernandez, J.A., Sanz, J., Paniagua, J.C., Hernandez, A.I., Martin, C.et al.Subcortical and cortical grey matter differences between Kraepelinian and non-Kraepelinian schizophrenia patients identified using voxel-based morphometry. Psychiatry Res 2010;184(1):16–22.CrossRefGoogle ScholarPubMed
Navari, S., Dazzan, P.Do antipsychotic drugs affect brain structure? A systematic and critical review of MRI findings. Psychol Med 2009;39(11):1763–1777.CrossRefGoogle ScholarPubMed
Paillère-Martinot, M., Caclin, A., Artiges, E., Poline, J.B., Joliot, M., Mallet, L.et al.Cerebral grey and white matter reductions and clinical correlates in patients with early onset schizophrenia. Schizophr Res 2001;50(1–2):19–26.CrossRefGoogle Scholar
Penttila, M., Jaaskelainen, E., Haapea, M., Tanskanen, P., Veijola, J., Ridler, K.et al.Association between duration of untreated psychosis and brain morphology in schizophrenia within the Northern Finland 1966 Birth Cohort. Schizophr Res 2010;123(2–3):145–152.CrossRefGoogle ScholarPubMed
Pressler, M., Nopoulos, P., Ho, B.C., Andreasen, N.C.Insular cortex abnormalities in schizophrenia: Relationship to symptoms and typical neuroleptic exposure. Biol Psychiatry 2005;57(4):394–398.CrossRefGoogle ScholarPubMed
Ridler, K., Veijola, J.M., Tanskanen, P., Miettunen, J., Chitnis, X., Suckling, J.et al.Fronto-cerebellar systems are associated with infant motor and adult executive functions in healthy adults but not in schizophrenia. Proc Natl Acad Sci U S A 2006;103(42):15651–15656.CrossRefGoogle ScholarPubMed
Rossi, A., Bustini, M., Prosperini, P., Marinangeli, M.G., Splendiani, A., Daneluzzo, E.et al.Neuromorphological abnormalities in schizophrenic patients with good and poor outcome. Acta Psychiatr Scand 2000;101(2):161–166.CrossRefGoogle ScholarPubMed
Sayo, A., Jennings, R.G., Van Horn, J.D.Study factors influencing ventricular enlargement in schizophrenia: A 20 year follow-up meta-analysis. Neuroimage 2012;59(1):154–167.CrossRefGoogle ScholarPubMed
Schmahmann, J.D., Doyon, J., McDonald, D., Holmes, C., Lavoie, K., Hurwitz, A.S.et al.Three-dimensional MRI atlas of the human cerebellum in proportional stereotaxic space. Neuroimage 1999;10(3 Pt 1):233–260.CrossRefGoogle ScholarPubMed
Shenton, M.E., Dickey, C.C., Frumin, M., McCarley, R.W.A review of MRI findings in schizophrenia. Schizophr Res 2001;49:1–52.CrossRefGoogle Scholar
Shepherd, A.M., Laurens, K.R., Matheson, S.L., Carr, V.J., Green, M.J.Systematic meta-review and quality assessment of the structural brain alterations in schizophrenia. Neurosci Biobehav Rev 2012;36(4):1342–1356.CrossRefGoogle Scholar
Spitzer, R.L., Gibbon, M., Endicott, J.Global Assessment Scale (GAS), Global Assessment of Functioning (GAF) scale, Social and Occupational Functioning Assessment Scale (SOFAS). In: Rush, AJ. editors. Handbook of Psychiatric Measures .Google Scholar
Spitzer, R., Williams, J., Gibbon, M.Structured Clinical Interview for DSM-III-R–Patient Edition. Biometrics Research Department New York State Psychiatric Institute; 1989.Google Scholar
Staal, W.G., Hulshoff Pol, H.E., Schnack, H.G., van Haren, N.E., Seifert, N., Kahn, R.S.Structural brain abnormalities in chronic schizophrenia at the extremes of the outcome spectrum. Am J Psychiatry 2001;158(7):2000. p. 1140–1142.CrossRefGoogle ScholarPubMed
Steen, R.G., Mull, C., McClure, R., Hamer, R.M., Lieberman, J.A.Brain volume in first-episode schizophrenia: systematic review and meta-analysis of magnetic resonance imaging studies. Br J Psychiatry 2006;188:510–518.CrossRefGoogle ScholarPubMed
Suckling, J., Brammer, M.J., Lingford-Hughes, A., Bullmore, E.T.Removal of extracerebral tissues in dual-echo magnetic resonance images via linear scale-space features. Magn Reson Imaging 1999;17(2):247–256.CrossRefGoogle ScholarPubMed
Suckling, J., Sigmundsson, T., Greenwood, K., Bullmore, E.T.A modified fuzzy clustering algorithm for operator independent brain tissue classification of dual echo MR images. Magn Reson Imaging 1999;17(7):1065–1076.CrossRefGoogle ScholarPubMed
Tanskanen, P., Ridler, K., Murray, G.K., Haapea, M., Veijola, J.M., Jaaskelainen, E.et al.Morphometric brain abnormalities in schizophrenia in a population-based sample: relationship to duration of illness. Schizophr Bull 2010;36(4):766–777.CrossRefGoogle Scholar
Tanskanen, P., Veijola, J.M., Piippo, U.K., Haapea, M., Miettunen, J.A., Pyhtinen, J.et al.Hippocampus and amygdala volumes in schizophrenia and other psychoses in the Northern Finland 1966 birth cohort. Schizophr Res 2005;75(2–3):283–294.CrossRefGoogle ScholarPubMed
Tzourio-Mazoyer, N., Landeau, B., Papathanassiou, D., Crivello, F., Etard, O., Delcroix, N.et al.Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 2002;15(1):273–289.CrossRefGoogle ScholarPubMed
van Haren, N.E., Cahn, W., Hulshoff Pol, H.E., Schnack, H.G., Caspers, E., Lemstra, A.et al.Brain volumes as predictor of outcome in recent-onset schizophrenia: A multi-center MRI study. Schizophr Res 2003;64(1):41–52.CrossRefGoogle ScholarPubMed
Vita, A., De Peri, L., Deste, G., Sacchetti, E.Progressive loss of cortical grey matter in schizophrenia: a meta-analysis and meta-regression of longitudinal MRI studies. Transl Psychiatry 2012;2:e19010.1038/tp.2012.116.CrossRefGoogle ScholarPubMed
Wilke, M., Kaufmann, C., Grabner, A., Pütz, B., Wetter, T.C., Auer, D.P.Grey matter-changes and correlates of disease severity in schizophrenia: a statistical parametric mapping study. Neuroimage 2001;13(5):814–824.CrossRefGoogle Scholar
Supplementary material: File

Jääskeläinen et al. supplementary material

Tables S1-S6

Download Jääskeläinen et al. supplementary material(File)
File 79.4 KB
Submit a response

Comments

No Comments have been published for this article.