CT abnormalities in late-onset schizophrenia and schizoaffective disorder correlate with number of psychotic episodes and cognitive dysfunction

Abstract

Introduction

Late-onset psychosis is associated with development of dementia. Search for neuroimaging signs in these patients is important.

Objectives

This study aimed to assess CT abnormalities and their clinical correlations in late-onset psychosis.

Methods

Patients with DSM-V diagnosis of late-onset schizophrenia (LOS, n= 43, age 65.2±9.4, 90% females) and schizoaffective disorder (LOSAP, n=9, age 64.9±5.8, 30% females) underwent CT and cognitive examination before discharge. Atrophy and ventricles enlargement were ranged from 0 (abs.) to 3 (sev.); vascular pathology - from 0 (abs.) to 2 (mult.). Patients were compared with 16 controls (age 58.1±10.8, 50% females). Nonparametric statistic was used.

Results

Patients had more severe frontal (χ² 19.7, р=0.003), temporal (χ² 10.7, р=0.097), parietal (χ² 21.7, р=0.001), cerebellar (χ² 14.8, р=0.005) atrophy and ventricles enlargement (χ² 15.6 р=0.016). 29 % of LOS and 44% of LOSAP patients had leukoaraiosis. All findings correlated with age. In patients ventricular enlargement correlated with number of psychotic episodes (r=0.338, р=0.014), lower MMSE (r=-0.314, p=0.045), immediate (r=-0.508, р=0.002) and delayed (r=-0.404, р=0.016) verbal recall. Temporal atrophy correlated with number of episodes (r=0.439, р=0.001), lower MMSE (r=-0.327, p=0.037) and immediate verbal recall (r=-0.339, p=0.046); cerebellum atrophy - with lower MMSE (r=-0.338, р=0.036) and FAB (r=-0.407, р=0.01); leukoaraiosis - with number of episodes (r=0.503, р=0.001), prolonged hospital stay (r=0.345, p=0.024); vascular pathology – with number of episodes (r=0.336, р=0.015), lower visual recall (r=-0.399, р=0.019), performance time in TMT-B (r=0.404, р=0.024).

Conclusions

Correlations between CT pathology, cognitive dysfunction and number of psychotic episodes may reflect progression of brain pathology due to psychosis.

Disclosure

No significant relationships.