Subgenual cingulate cortex volume in first-episode psychosis.

Yoshio Hirayasu,Martha E Shenton,Ron Kikinis,Iris A Fischer,Robert W Mccarley,Carlos Zarate,Ferenc A Jolesz,Deborah Yurgelun-Todd,Jun Soo Kwon,Dean F Salisbury,Cynthia G Wible

doi:10.1176/ajp.156.7.1091

Yoshio Hirayasu, Martha E Shenton + Show 9 more

Open Access

https://doi.org/10.1176/ajp.156.7.1091

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Abstract

Gray matter volume and glucose utilization have been reported to be reduced in the left subgenual cingulate of subjects with familial bipolar or unipolar depression. It is unclear whether these findings are secondary to recurrent illness or are part of a familial/genetic syndrome. The authors' goal was to clarify these findings. Volumetric analyses were performed by using magnetic resonance imaging in 41 patients experiencing their first episode of affective disorder or schizophrenia and in 20 normal comparison subjects. The left subgenual cingulate volume of the patients with affective disorder who had a family history of affective disorder was smaller than that of patients with affective disorder with no family history of the illness and the normal comparison subjects. Patients with schizophrenia did not differ from comparison subjects in left subgenual cingulate volume. Left subgenual cingulate abnormalities are present at first hospitalization for psychotic affective disorder in patients who have a family history of affective disorder.

Highlights

None of the demographic or clinical measures differed between patients with affective disorder who did or did not have a family history of affective disorder
Follow-up analysis of covariance (ANCOVA) revealed that the subgenual cingulate volume of patients with affective disorder who had a family history of affective disorder was significantly smaller than that of normal comparison subjects (F=4.97, df=1, 30, p=0.03) and patients with affective disorder who had no family history of the disorder (F=6.22, df=1, 20, p= 0.02)
There was a trend for the subgenual cingulate volume of patients with schizophrenia to be smaller than that of patients with affective disorder who had no family history of the disorder (F=3.25, df=1, 23, p= 0.08)

Summary

Objective

Gray matter volume and glucose utilization have been reported to be reduced in the left subgenual cingulate of subjects with familial bipolar or unipolar depression. Drevets and coworkers [4] found that patients with chronic affective disorder who had a family history of affective disorder showed both smaller gray matter volume and lower levels of PET activity in the left subgenual cingulate, below the corpus callosum genu These authors did not determine, whether the volume reduction resulted from chronic illness or was specific to affective disorder. To test the hereditary effect of affective disorder on subgenual cingulate volume, we performed a mixed-model ANCOVA with group (patients with affective disorder who had a family history of affective disorder, patients with affective disorder who had no family history of the disorder, patients with schizophrenia, and comparison subjects) as the between-subjects factor and side (left versus right) as the within-subjects factor, covarying for age and intracranial contents.

RESULTS

DISCUSSION

Hollingshead AB