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Brain pathology in first-episode psychosis: magnetization transfer imaging provides additional information to MRI measurements of volume loss.

Price G, Cercignani M, Chu EM, Barnes TR, Barker GJ, Joyce EM, Ron MA - Neuroimage (2009)

Bottom Line: In patients, MTR was reduced in right entorhinal cortex, fusiform, dentate and superior frontal gyri and in left superior frontal and inferior/rostral cingulate gyri.Grey matter volume was reduced in right insula, frontal operculum and middle and superior temporal gyri and in left middle temporal gyrus.White matter volume loss was found adjacent to grey matter loss.

View Article: PubMed Central - PubMed

Affiliation: Institute of Neurology, University College London, Queen Square, London, UK. g.price@ion.ucl.ac.uk

ABSTRACT

Background: Loss of brain volume in first-episode psychosis can be detected using conventional magnetic resonance imaging (MRI), but subtle changes--not leading to reduction in volume--that may contribute to clinical and cognitive abnormalities, may go undetected. Magnetization transfer imaging (MTI), a technique more sensitive to subtle neuropathological changes than conventional MRI, could yield important information on the extent and nature of structural abnormalities.

Methods: Forty-eight patients (33 males) from a population-based sample with first-episode psychosis (41 with schizophrenia and 7 with schizoaffective psychosis) and 47 healthy volunteers (27 males) were studied. Differences in magnetization transfer ratio (MTR) and white and grey matter volumes between groups were investigated.

Results: In patients, MTR was reduced in right entorhinal cortex, fusiform, dentate and superior frontal gyri and in left superior frontal and inferior/rostral cingulate gyri. Grey matter volume was reduced in right insula, frontal operculum and middle and superior temporal gyri and in left middle temporal gyrus. Grey matter volume increases were seen in patients in the superior frontal gyrus. White matter volume loss was found adjacent to grey matter loss. In patients MTR was lower in all areas of volumetric differences between groups suggesting that both changes may be related. Similar findings were observed when patients with schizoaffective psychosis were removed from the analysis. The correlations between clinical and MRI parameters did not survive correction for multiple comparisons.

Conclusions: MTI frontal and temporal abnormalities suggesting neuroaxonal and myelin changes were more extensive in our patients than those detected with conventional MRI. Our findings also suggest that there is regional variation in the severity of structural brain abnormalities.

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Related in: MedlinePlus

90% Confidence Intervals in the most significant clusters for white and grey matter decreases in patients, grey matter increases in patients and MTR reductions in patients. Control (n = 47) data are plotted first (1 = Controls, 2 = Patients) and coordinates are shown in the glass brain (arrow) and vertical axis.
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fig2: 90% Confidence Intervals in the most significant clusters for white and grey matter decreases in patients, grey matter increases in patients and MTR reductions in patients. Control (n = 47) data are plotted first (1 = Controls, 2 = Patients) and coordinates are shown in the glass brain (arrow) and vertical axis.

Mentions: Cluster sizes and coordinates are shown in Table 1 and Fig. 1 and plots for 90% Confidence Intervals for the most significant cluster in each group difference are shown in Fig. 2.


Brain pathology in first-episode psychosis: magnetization transfer imaging provides additional information to MRI measurements of volume loss.

Price G, Cercignani M, Chu EM, Barnes TR, Barker GJ, Joyce EM, Ron MA - Neuroimage (2009)

90% Confidence Intervals in the most significant clusters for white and grey matter decreases in patients, grey matter increases in patients and MTR reductions in patients. Control (n = 47) data are plotted first (1 = Controls, 2 = Patients) and coordinates are shown in the glass brain (arrow) and vertical axis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2806943&req=5

fig2: 90% Confidence Intervals in the most significant clusters for white and grey matter decreases in patients, grey matter increases in patients and MTR reductions in patients. Control (n = 47) data are plotted first (1 = Controls, 2 = Patients) and coordinates are shown in the glass brain (arrow) and vertical axis.
Mentions: Cluster sizes and coordinates are shown in Table 1 and Fig. 1 and plots for 90% Confidence Intervals for the most significant cluster in each group difference are shown in Fig. 2.

Bottom Line: In patients, MTR was reduced in right entorhinal cortex, fusiform, dentate and superior frontal gyri and in left superior frontal and inferior/rostral cingulate gyri.Grey matter volume was reduced in right insula, frontal operculum and middle and superior temporal gyri and in left middle temporal gyrus.White matter volume loss was found adjacent to grey matter loss.

View Article: PubMed Central - PubMed

Affiliation: Institute of Neurology, University College London, Queen Square, London, UK. g.price@ion.ucl.ac.uk

ABSTRACT

Background: Loss of brain volume in first-episode psychosis can be detected using conventional magnetic resonance imaging (MRI), but subtle changes--not leading to reduction in volume--that may contribute to clinical and cognitive abnormalities, may go undetected. Magnetization transfer imaging (MTI), a technique more sensitive to subtle neuropathological changes than conventional MRI, could yield important information on the extent and nature of structural abnormalities.

Methods: Forty-eight patients (33 males) from a population-based sample with first-episode psychosis (41 with schizophrenia and 7 with schizoaffective psychosis) and 47 healthy volunteers (27 males) were studied. Differences in magnetization transfer ratio (MTR) and white and grey matter volumes between groups were investigated.

Results: In patients, MTR was reduced in right entorhinal cortex, fusiform, dentate and superior frontal gyri and in left superior frontal and inferior/rostral cingulate gyri. Grey matter volume was reduced in right insula, frontal operculum and middle and superior temporal gyri and in left middle temporal gyrus. Grey matter volume increases were seen in patients in the superior frontal gyrus. White matter volume loss was found adjacent to grey matter loss. In patients MTR was lower in all areas of volumetric differences between groups suggesting that both changes may be related. Similar findings were observed when patients with schizoaffective psychosis were removed from the analysis. The correlations between clinical and MRI parameters did not survive correction for multiple comparisons.

Conclusions: MTI frontal and temporal abnormalities suggesting neuroaxonal and myelin changes were more extensive in our patients than those detected with conventional MRI. Our findings also suggest that there is regional variation in the severity of structural brain abnormalities.

Show MeSH
Related in: MedlinePlus