Midline Brain Abnormalities Across Psychotic and Mood Disorders

Abstract

Patients with schizophrenia are known to have increased prevalence of abnormalities in midline brain structures, such as a failure of the septum pellucidum to fuse (cavum septum pellucidum) and the absence of the adhesio interthalamica. This is the first study to investigate the prevalence of these abnormalities across a large multidiagnostic sample. Presence of cavum septum pellucidum and absence of the adhesio interthalamica was assessed in 639 patients with chronic schizophrenia, delusional disorder, schizoaffective disorder, bipolar disorder, major depressive disorder, or a first episode of psychosis, mania or unipolar depression. This was compared with 223 healthy controls using logistic-regression-derived odds ratios (OR). Patients with psychotic or mood disorders showed an increased prevalence of both abnormalities (OR of cavum septum pellucidum = 2.1, OR of absence of the adhesio interthalamica = 2.6, OR of both cavum septum pellucidum and absence of the adhesio interthalamica = 3.8, all P < .001). This increased prevalence was separately observed in nearly all disorders as well as after controlling for potential confounding factors. This study supports a general increased prevalence of midline brain abnormalities across mood and psychotic disorders. This nonspecificity may suggest that these disorders share a common neurodevelopmental etiology.

Use of Psychotropic Medications and Visits to Psychiatrists and Psychologists among Individuals with Nonsyndromic Oral Clefts: A Population‐Based Cohort Study

“…Our finding of higher risk of using antipsychotics for individuals with CLP and CP and increased use of stimulants for male subjects with CP are consistent with our previous study of the same population (Pedersen et al, ), which found increased risk of hospitalization with a diagnosis of schizophrenia‐like disorders for individuals with CLP or CP and with a diagnosis of behavioral and emotional disorders (including hyperkinetic disorder) for male subjects with CP. The increased use of antipsychotics and stimulants among individuals with OC is also in line with reports of an association between nonsyndromic OC and midline brain anomalies in male subjects (Nopoulos et al, ; Weinberg et al, ), which, in other studies, have been associated with schizophrenia, mental retardation, and developmental delay (Nopoulos et al, ; Bodensteiner et al, ; Landin–Romero et al, ). They are also consistent with prior studies reporting increased frequency of CP among patients with schizophrenia (Gourion et al, ) and increased rates of hyperactivity, impulsivity, and inattention among individuals with nonsyndromic OCs (Nopoulos et al, ; Wehby et al, ).…”

“…The increased risks were found for schizophrenia‐like disorders, mental retardation, and pervasive developmental disorders for individuals with CLP and CP and for behavioral and emotional disorders (including hyperkinetic disorder) for individuals with CP. These findings are consistent with neuroimaging studies that have reported increased rates of midline brain anomalies among male patients with nonsyndromic OC (Nopoulos et al, ; Weinberg et al, ), which, in other studies, have been associated with schizophrenia, developmental delay, and mental retardation (Nopoulos et al, ; Bodensteiner et al, ; Landin–Romero et al, ). They are also consistent with reports of increased frequency of CP among patients with schizophrenia (Gourion et al, ) and increased rates of hyperactivity, impulsivity, and inattention in boys with OC (Nopoulos et al, ; Wehby et al, ).…”

The nucleus reuniens of the thalamus sits at the nexus of a hippocampus and medial prefrontal cortex circuit enabling memory and behavior

“…abnormalities have been specifically attributed to RE dysfunction (Lisman et al 2010;Lisman 2012;Duan et al 2015), and the massa intermedia (or interthalamic adhesion) has been frequently reported as absent, or shorter/smaller in schizophrenic patients (e.g., Nopoulos et al 2001;Ceyhan et al 2008;Takahashi et al 2008;Trzesniak et al 2011Trzesniak et al , 2012Landin-Romero et al 2016). In epilepsy, the hyperexcitability critical for the generation and/or propagation of hippocampal seizure activity (Ang et al 2006) has been suggested to be due, in part, to the loss of RE-induced feedforward inhibition targeting CA1 (Dolleman-van der Weel et al 1997Dolleman-van der Weel and Witter 2000).…”

Prevalence of cavum vergae in psychosis and mood spectrum disorders

“…Data for this study have been previously acquired, preprocessed and analyzed using the same 1.5 Tesla GE Signa scanner in a series of neuroimaging studies evaluating structural and functional differences between patients with psychotic or mood disorders and healthy controls Canales-Rodriguez et al, 2014;Landin-Romero et al, 2015;Pomarol-Clotet et al, 2010). A highresolution structural T1 MRI sequence with the following parameters had been used: number of axial slices = 180; slice thickness = 1mm, slice gap = 0mm, matrix size = 512×512; voxel resolution 0.5×0.5×1mm 3 ; echo time (TE) = 4ms, repetition time (TR) = 2000ms, flip angle = 15°.…”