Abstract

IntroductionAlthough schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology, their neural underpinnings are still under investigation. Here, structural Magnetic Resonance Imaging (MRI) data collected from a large sample of BD and SCZ patients and healthy controls (HC) were analyzed in terms of gray matter volume (GMV) using both voxel based morphometry (VBM) and a region of interest (ROI) approach.MethodsThe analysis was conducted on two datasets, Dataset1 (802 subjects: 243 SCZ, 176 BD, 383 HC) and Dataset2, a homogeneous subset of Dataset1 (301 subjects: 107 HC, 85 BD and 109 SCZ). General Linear Model analyses were performed 1) at the voxel-level in the whole brain (VBM study), 2) at the regional level in the anatomical regions emerged from the VBM study (ROI study). The GMV comparison across groups was integrated with the analysis of GMV correlates of different clinical dimensions.ResultsThe VBM results of Dataset1 showed 1) in BD compared to HC, GMV deficits in right cingulate, superior temporal and calcarine cortices, 2) in SCZ compared to HC, GMV deficits in widespread cortical and subcortical areas, 3) in SCZ compared to BD, GMV deficits in insula and thalamus (p<0.05, cluster family wise error corrected). The regions showing GMV deficits in the BD group were mostly included in the SCZ ones. The ROI analyses confirmed the VBM results at the regional level in most of the clusters from the SCZ vs. HC comparison (p<0.05, Bonferroni corrected). The VBM and ROI analyses of Dataset2 provided further evidence for the enhanced GMV deficits characterizing SCZ. Based on the clinical-neuroanatomical analyses, we cannot exclude possible confounding effects due to 1) age of onset and medication in BD patients, 2) symptoms severity in SCZ patients.ConclusionOur study reported both shared and specific neuroanatomical characteristics between the two disorders, suggesting more severe and generalized GMV deficits in SCZ, with a specific role for insula and thalamus.

Highlights

  • Schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology, their neural underpinnings are still under investigation

  • The voxel based morphometry (VBM) results of Dataset1 showed 1) in BD compared to healthy controls (HC), gray matter volume (GMV) deficits in right cingulate, superior temporal and calcarine cortices, 2) in SCZ compared to HC, GMV deficits in widespread cortical and subcortical areas, 3) in SCZ compared to BD, GMV deficits in insula and thalamus (p

  • Both psychotic and non-psychotic BD patients (PBD, NPBD) as well as BD type I (BD-I) and BD type II (BD-I) patients took part to the study: PBD patients were in minority, being 42 out of 176, whereas BD-I patients were in majority, being 111 out of 176

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Summary

Introduction

Schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology, their neural underpinnings are still under investigation. Voxel-Based Morphometry (VBM) meta-analyses reported gray matter volume (GMV) deficits in insula, thalamus, cingulate cortex, medial frontal gyrus, middle and superior temporal gyri in SCZ [8, 10], and in anterior cingulate cortex, inferior frontal gyrus, insula, middle and superior temporal gyri and pole and claustrum in BD [8, 11]. These studies suggest overlapping areas of GMV reduction among the two disorders, and provide evidence for the larger extent of the deficits in SCZ than in BD [2, 8]. Region-based studies on SCZ vs. BD found in BD increased volume in the right amygdala and decreased volume in the bilateral ventricles compared to SCZ [1]

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