Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
권호 표지

Comparison of Fornix and Stria Terminalis Connectivity among First-Episode Schizophrenia, Chronic Schizophrenia and Healthy Controls

초발 조현병, 만성 조현병과 건강 대조군의 뇌활과 분계섬유줄 연결성 비교

  • Lee, Arira (Department of Psychiatry, CHA Bundang Medical Center, CHA University) ;
  • Yun, Mirim (Department of Psychiatry, Hanyang University College of Medicine) ;
  • Yook, Ki Hwan (Department of Psychiatry, CHA Bundang Medical Center, CHA University) ;
  • Choi, Tai Kiu (Department of Psychiatry, CHA Bundang Medical Center, CHA University) ;
  • Lee, Kang Soo (Department of Psychiatry, CHA Bundang Medical Center, CHA University) ;
  • Bang, Minji (Department of Psychiatry, CHA Bundang Medical Center, CHA University) ;
  • Lee, Sang-Hyuk (Department of Psychiatry, CHA Bundang Medical Center, CHA University)
  • 이아리라 (차의과학대학교 분당차병원 정신건강의학과) ;
  • 윤미림 (한양대학교 의과대학 정신건강의학교실) ;
  • 육기환 (차의과학대학교 분당차병원 정신건강의학과) ;
  • 최태규 (차의과학대학교 분당차병원 정신건강의학과) ;
  • 이강수 (차의과학대학교 분당차병원 정신건강의학과) ;
  • 방민지 (차의과학대학교 분당차병원 정신건강의학과) ;
  • 이상혁 (차의과학대학교 분당차병원 정신건강의학과)
  • Received : 2018.08.03
  • Accepted : 2018.12.20
  • Published : 2019.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives Disrupted integrities of the fornix and stria terminalis have been suggested in schizophrenia. However, very few studies have focused on the fornix and stria terminalis comparing first-episode schizophrenia (FESZ), chronic schizophrenia (CS), and healthy controls (HCs) with the application of diffusion-tensor imaging (DTI) technique. The objective of this study is to compare the connectivity of the fornix and stria terminalis among FESZ, CS, and HCs. Methods We included the 44 FESZ patients, 39 CS patients and 20 HCs in this study. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics to analyze the connectivity of fornix and stria terminalis. In addition, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to evaluate clinical symptom severities. Results There were no significant differences between the FESZ, CS, and HCs in age, sex, education years. The SAPS and SANS scores of the schizophrenia groups showed no significant differences. FA values of the right fornix cres/stria terminalis in the CS group were significantly lower than those in FESZ and HCs. There were no significant differences of FA values of the right fornix cres/stria terminalis between the FESZ and the HCs. Pearson correlation analyses revealed that significant correlation between FA values of the right fornix cres/stria terminalies of the the FESZ group and positive, negative symptom scales, and FA values of the right fornix cres/stria terminalis of the CS group and negative symptom scales. Conclusions This study shows that FA values of the fornix and stria terminalis in the CS were lower than in the FESZ and the HCs. These results suggest that the fornix and stria terminalis can play a role in pathophysiology of schizophrenia. Thus current study can broaden our understanding of the pathophysiology of schizophrenia.

Keywords

References

  1. Heckers S. Neuroimaging studies of the hippocampus in schizophrenia. Hippocampus 2001;11:520-528. https://doi.org/10.1002/hipo.1068
  2. Barger N, Hanson KL, Teffer K, Schenker-Ahmed NM, Semendeferi K. Evidence for evolutionary specialization in human limbic structures. Front Hum Neurosci 2014;8:277. https://doi.org/10.3389/fnhum.2014.00277
  3. Bogerts B, Meertz E, Schonfeldt-Bausch R. Basal ganglia and limbic system pathology in schizophrenia. A morphometric study of brain volume and shrinkage. Arch Gen Psychiatry 1985;42:784-791. https://doi.org/10.1001/archpsyc.1985.01790310046006
  4. Jeste DV, Lohr JB. Hippocampal pathologic findings in schizophrenia. A morphometric study. Arch Gen Psychiatry 1989;46:1019-1024. https://doi.org/10.1001/archpsyc.1989.01810110061009
  5. McCarley RW, Wible CG, Frumin M, Hirayasu Y, Levitt JJ, Fischer IA, et al. MRI anatomy of schizophrenia. Biol Psychiatry 1999;45:1099-1119. https://doi.org/10.1016/S0006-3223(99)00018-9
  6. Nelson MD, Saykin AJ, Flashman LA, Riordan HJ. Hippocampal volume reduction in schizophrenia as assessed by magnetic resonance imaging: a meta-analytic study. Arch Gen Psychiatry 1998;55:433-440. https://doi.org/10.1001/archpsyc.55.5.433
  7. Zahajszky J, Dickey CC, McCarley RW, Fischer IA, Nestor P, Kikinis R, et al. A quantitative MR measure of the fornix in schizophrenia. Schizophr Res 2001;47:87-97. https://doi.org/10.1016/S0920-9964(00)00051-7
  8. Fitzsimmons J, Kubicki M, Smith K, Bushell G, Estepar RS, Westin CF, et al. Diffusion tractography of the fornix in schizophrenia. Schizophr Res 2009;107:39-46. https://doi.org/10.1016/j.schres.2008.10.022
  9. Luck D, Malla AK, Joober R, Lepage M. Disrupted integrity of the fornix in first-episode schizophrenia. Schizophr Res 2010;119:61-64. https://doi.org/10.1016/j.schres.2010.03.027
  10. Fitzsimmons J, Hamoda HM, Swisher T, Terry D, Rosenberger G, Seidman LJ, et al. Diffusion tensor imaging study of the fornix in first episode schizophrenia and in healthy controls. Schizophr Res 2014;156:157-160. https://doi.org/10.1016/j.schres.2014.04.022
  11. Ellison-Wright I, Bullmore E. Meta-analysis of diffusion tensor imaging studies in schizophrenia. Schizophr Res 2009;108:3-10. https://doi.org/10.1016/j.schres.2008.11.021
  12. Kelly S, Jahanshad N, Zalesky A, Kochunov P, Agartz I, Alloza C, et al. Widespread white matter microstructural differences in schizophrenia across 4322 individuals: results from the ENIGMA Schizophrenia DTI Working Group. Mol Psychiatry 2018;23:1261-1269. https://doi.org/10.1038/mp.2017.170
  13. Lieberman JA. Is schizophrenia a neurodegenerative disorder? A clinical and neurobiological perspective. Biol Psychiatry 1999;46:729-739. https://doi.org/10.1016/S0006-3223(99)00147-X
  14. First MB, Gibbon M. The structured clinical interview for DSM-IV axis I disorders (SCID-I) and the structured clinical interview for DSM-IV axis II disorders (SCID-II). In: Hilsenroth MJ, Segal DL., editors. Comprehensive Handbook of Psychological Assessment, Volume 2: Personality Assessment. Hoboken, NJ: John Wiley & Sons;2004. p.134-143.
  15. Breitborde NJ, Srihari VH, Woods SW. Review of the operational definition for first-episode psychosis. Early Interv Psychiatry 2009;3:259-265. https://doi.org/10.1111/j.1751-7893.2009.00148.x
  16. Minas IH, Stuart GW, Klimidis S, Jackson HJ, Singh BS, Copolov DL. Positive and negative symptoms in the psychoses: multidimensional scaling of SAPS and SANS items. Schizophr Res 1992;8:143-156. https://doi.org/10.1016/0920-9964(92)90031-Y
  17. Andreasen NC. The scale for the Assessment of Negative Symptoms (SANS): conceptual and theoretical foundations. Br J Psychiatry Suppl 1989;(7):49-58.
  18. Smith SM, Jenkinson M, Johansen-Berg H, Rueckert D, Nichols TE, Mackay CE, et al. Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data. Neuroimage 2006;31:1487-1505. https://doi.org/10.1016/j.neuroimage.2006.02.024
  19. Smith SM, Jenkinson M, Woolrich MW, Beckmann CF, Behrens TE, Johansen-Berg H, et al. Advances in functional and structural MR image analysis and implementation as FSL. Neuroimage 2004;23 Suppl 1:S208-S219. https://doi.org/10.1016/j.neuroimage.2004.07.051
  20. Mori S, Aggarwal M. In vivo magnetic resonance imaging of the human limbic white matter. Front Aging Neurosci 2014;6:321.
  21. Herz MI, Liberman RP, McGlashan TH, Lieberman JA, Wyatt RJ, Marder SR, et al. Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry 1997;154:1-63.
  22. Woods SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry 2003;64:663-667. https://doi.org/10.4088/JCP.v64n0607
  23. Filippi M, Canu E, Gasparotti R, Agosta F, Valsecchi P, Lodoli G, et al. Patterns of brain structural changes in first-contact, antipsychotic drug-naive patients with schizophrenia. AJNR Am J Neuroradiol 2014;35:30-37. https://doi.org/10.3174/ajnr.A3583
  24. Koch K, Wagner G, Dahnke R, Schachtzabel C, Schultz C, Roebel M, et al. Disrupted white matter integrity of corticopontine-cerebellar circuitry in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2010;260:419-426. https://doi.org/10.1007/s00406-009-0087-0
  25. Lee SH, Kubicki M, Asami T, Seidman LJ, Goldstein JM, Mesholam-Gately RI, et al. Extensive white matter abnormalities in patients with first-episode schizophrenia: a Diffusion Tensor Iimaging (DTI) study. Schizophr Res 2013;143:231-238. https://doi.org/10.1016/j.schres.2012.11.029
  26. Farley IJ, Price KS, McCullough E, Deck JH, Hordynski W, Hornykiewicz O. Norepinephrine in chronic paranoid schizophrenia: above-normal levels in limbic forebrain. Science 1978;200:456-458. https://doi.org/10.1126/science.644310