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Insular pathology in young people with high-functioning autism and first-episode psychosis

Published online by Cambridge University Press:  24 April 2017

M. Parellada ,
L. Pina-Camacho ,
C. Moreno ,
Y. Aleman ,
M.-O. Krebs ,
M. Desco ,
J. Merchán-Naranjo ,
A. Del Rey-Mejías ,
L. Boada  and
C. Llorente
...Show all authors
M. Parellada*
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain
L. Pina-Camacho
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, SE5 8AF, London, UK
C. Moreno
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain
Y. Aleman
Affiliation:
Department of Experimental Medicine, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Ibiza 43, 28009 Madrid, Spain
M.-O. Krebs
Affiliation:
INSERM, U894, “Psychophysiology of psychiatric disorders Lab,” Center for psychiatry and neurosciences, University Paris Descartes, Sorbonne Paris Cité; Institut de Psychiatrie-GDR 3557; and Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France
M. Desco
Affiliation:
Department of Experimental Medicine, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Ibiza 43, 28009 Madrid, Spain Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid, Madrid, Spain
J. Merchán-Naranjo
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain
A. Del Rey-Mejías
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain Department of Methodology, School of Psychology, Universidad Complutense, Madrid, Spain
L. Boada
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain
C. Llorente
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain
D. Moreno
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain
C. Arango
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain
J. Janssen
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Ibiza 43, 28009 Madrid, Spain Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
*
*Address for correspondence: M. Parellada, M.D., Ph.D., Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Ibiza 43, 28009 Madrid, Spain. (Email: parelladahggm@gmail.com)
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Abstract

Background

Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions.

Methods

Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored.

Results

Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = −0.28, p = 0.041) and left posterior (r = −0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of ‘autistic-like’ symptoms (r = −0.30, p = 0.028).

Conclusions

The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.

Keywords

Autism spectrum disordersfirst-episode psychosisinsulamorphologycortical thicknessvolume
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 14 , October 2017 , pp. 2472 - 2482
Copyright
Copyright © Cambridge University Press 2017 

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