1110-1105 © 2014 Egyptian Journal of Psychiatry DOI: 10.4103/1110-1105.127264

Original article 1

Introduction

Caudate nucleus volume in schizophrenia, bipolar, and depressive psychosisMaha ELTayebania, Mamdoh ElGamalb, Osama Gadoc, Mohamed Samer Abdelaald

IntroductionThe caudate nucleus (CN) is a crucial component of the ventral striatum and part of the striatal–thalamic circuits that is modulated by limbic structure to subserve emotional processing. MRI studies examining the CN have yielded equivocal, mixed results. We aimed to examine the

Materials and methods(i) The CN was manually traced on MRI scans from 49 schizophrenic patients, 21 bipolar patients, and 20 patients with depressive psychosis as well as 23 healthy control individuals both at baseline and after 2 years. (ii) Structured SCID interviews of DSM-IV, HDRS, YMRS as well as PANSS were conducted. (iii) WMS-III and WAIS were used to test cognitive function

Results

a magnitude of around 18.5%. (ii) Schizophrenic and depressive patients showed a modest volume reduction in CN (8.5 and 12.5%, respectively). (iii) Only bipolar patients showed cognitive dysfunction associated with a 1% progressive reduction in CN size after 2 years of follow-up. Clinical importance was unclear for depressive and schizophrenia patients.Conclusion and recommendation

the illness, but it is unclear whether it is primary or secondary to other structural changes. Study of the shape, functional changes in CN as well as areas connected to it may uncover the primary mechanisms of bipolar psychosis.

Keywords:bipolar disorder, caudate volume, cognition, MRI, psychotic depression, schizophrenia

Egypt J Psychiatr 35(1):1–13© 2014 Egyptian Journal of Psychiatry1110-1105

aDepartment of Psychiatry, Faculty of Medicine, Alexandria University, Alexandria, bDepartment of Psychiatry, Faculty of Medicine, Cairo University, Cairo, cDepartment of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt and dFRCR, Department of MRI, Hadi Hospital, Kuwait

Correspondence to Maha ELTayebani, MD, Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt Tel: +20 965 99169015; fax: +20 965 24841123; e-mail: elgamalmamdoh@yahoo.com

Received 11 January 2012 Accepted 17 March 2012

Egyptian Journal of Psychiatry 2014, 35(1):1–13

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Materials and methodsPlace and participants

Control participants

Design

Baseline assessment (2 years)

Follow-up (2 years)

Process

Caudate nucleus volume ELTayebani et al. 3

MeasuresPositive and Negative Syndrome Scale (PANSS) (Kay et al., 1987)

Hamilton Depression Rating Scales (HDRS) (Hamilton, 1960; Hamilton, 1967)

Young Mania Rating Scale (YMRS) (Young et al., 1978)

Cognitive tests

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Simpson–Angus extrapyramidal side effect scale (Simpson and Angus, 1970)

Magnetic resonance imaging study

Imagining protocol and volume measurements

Magnetic resonance image acquisition and processing

Statistical methodology

Caudate nucleus volume ELTayebani et al. 5

Results

Clinical symptoms

Table 1 Group comparison of caudate nucleus size and clinical characteristics for schizophrenia, bipolar, and depressive psychosis patients and the control group

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Figure 1

on the right (a–c) compared with normal caudate volumes in healthy controls (d–f, mirror images).

a b

c d

e f

Caudate nucleus volume ELTayebani et al. 7

Cognitive function

Figure 2

Group comparison of right caudate nucleus size for schizophrenia, bipolar, and depressive psychosis patients and the control group at the baseline stage.

Figure 3

Group comparison of left caudate nucleus size for schizophrenia, bipolar, and depressive psychosis patients and the control group at the baseline stage.

Figure 4

Comparison of right caudate nucleus size for schizophrenia, bipolar, and depressive psychosis patients and the control group at baseline and after 2 years of follow-up.

Figure 5

compared with other psychoses patients and the control group at baseline assessment.

Figure 6

Progressive reduction in overall nucleus size for bipolar psychosis patients after 2 years compared with schizophrenia and depressive patients and the control group.

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Caudate nucleus correlates

Table 2 Mean scores of HDRS, YMRS, PANSS in schizophrenia, bipolar, and depressive psychoses at baseline and after 2 years of follow-up

Caudate nucleus volume ELTayebani et al. 9

Cognitive functionsSchizophrenia group

Depressive psychosis group

Bipolar groupAt baseline

Figure 7 Figure 8

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Assessments after 2 years of treatment

Discussion

Table 4 Relation between cognitive functions and caudate nucleus size in bipolar patients at baseline and after 2 years of follow-up

Caudate nucleus volume ELTayebani et al. 11

Clinical and cognitive correlates

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Conclusion and recommendations

Strenghtens of the study

Limitations

Acknowledgements

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