RESUMO
BACKGROUND: Some neuroimaging studies have supported the hypothesis of progressive brain changes after a first episode of psychosis. We aimed to determine whether (i) first-episode psychosis patients would exhibit more pronounced brain volumetric changes than controls over time and (ii) illness course/treatment would relate to those changes. METHOD: Longitudinal regional grey matter volume and ventricle:brain ratio differences between 39 patients with first-episode psychosis (including schizophrenia and schizophreniform disorder) and 52 non-psychotic controls enrolled in a population-based case-control study. RESULTS: While there was no longitudinal difference in ventricle:brain ratios between first-episode psychosis subjects and controls, patients exhibited grey matter volume changes, indicating a reversible course in the superior temporal cortex and hippocampus compared with controls. A remitting course was related to reversal of baseline temporal grey matter deficits. CONCLUSIONS: Our findings do not support the hypothesis of brain changes indicating a progressive course in the initial phase of psychosis. Rather, some brain volume abnormalities may be reversible, possibly associated with a better illness course.
Assuntos
Encéfalo/patologia , Transtornos Psicóticos/patologia , Adulto , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Esquizofrenia/patologia , Fatores SocioeconômicosRESUMO
Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t21 = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t21 = 1.99, P = 0.06), right amygdala (8%, t21 = 1.83, P = 0.08), left amygdala (5%, t21 = 1.78, P = 0.09) and left hippocampus (9%, t21 = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures.
Assuntos
Transtorno de Pânico/patologia , Lobo Temporal/patologia , Adulto , Tonsila do Cerebelo/patologia , Estudos de Casos e Controles , Feminino , Hipocampo/patologia , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
Induction of mania or hypomania related to the use of atypical antipsychotics among patients with no history of mood disorders has been previously reported. We reported the cases of three schizophrenic patients with no previous history of mood disorders (including no history of mania or hypomania episodes) who developed hypomania associated to the use of atypical antipsychotics.
Assuntos
Antipsicóticos/efeitos adversos , Transtorno Bipolar/induzido quimicamente , Risperidona/efeitos adversos , Esquizofrenia/tratamento farmacológico , Adulto , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Feminino , Humanos , Masculino , Índice de Gravidade de DoençaRESUMO
Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9 percent smaller than that of controls (t21 = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7 percent, t21 = 1.99, P = 0.06), right amygdala (8 percent, t21 = 1.83, P = 0.08), left amygdala (5 percent, t21 = 1.78, P = 0.09) and left hippocampus (9 percent, t21 = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures