Neuroanatomical substrate of chronic psychosis in epilepsy: an MRI study
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ORIGINAL RESEARCH
Neuroanatomical substrate of chronic psychosis in epilepsy: an MRI study Noriaki Hirakawa 1 & Hironori Kuga 1,2 & Yoji Hirano 1 & Jinya Sato 1 & Naoya Oribe 1,3 & Itta Nakamura 1 & Shogo Hirano 1 & Takefumi Ueno 1,3 & Yuko Oda 1 & Osamu Togao 4 & Akio Hiwatashi 4 & Hiroshi Honda 4 & Shigenobu Kanba 1 & Toshiaki Onitsuka 1
# The Author(s) 2019
Abstract There may be different neural bases between subjects with epilepsy only (EP) and interictal chronic epilepsy psychosis (EPS). However, there have been few structural MRI studies of EPS. The current study was conducted to investigate the neural substrate of EPS. T1-weighted images were analyzed in 14 patients with EPS and 14 strictly-matched patients with EP. We conducted volume comparison in the whole brain using voxel-based morphometry (VBM). The VBM method revealed that EPS patients exhibited significantly reduced gray matter volumes in the left postcentral gyrus and the left supra marginal gyrus compared with EP patients (adjusted p = 0.029, FDR corrected q; k = 319 voxels). For clinical correlations, there were no significant associations between psychotic symptoms and gray matter volumes in the left postcentral gyrus and the left supra marginal gyrus. VBM analysis revealed that reduced gray matter volumes in the left postcentral gyrus and the left supra marginal gyrus may be crucial regions for EPS. Keywords Chronic interictal epileptic psychosis . MRI . Left postcentral gyrus . Left supra marginal gyrus
Introduction The psychoses of epilepsy can be categorized by their temporal relationships with seizures, commonly referred to as ictal, postictal and interictal psychoses. Chronic interictal epileptic psychosis (EPS) subjects show delusional symptoms similar to those seen in patients with schizophrenia, although thought disorders are rare and disintegration of mental boundaries is usually absent in EPS (Nadkarni et al. 2007). On the one hand, EPS subjects have been reported to show less negative
* Toshiaki Onitsuka [email protected] 1
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan
2
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
3
Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, Saga, Japan
4
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
symptoms and social anhedonia compared with patients with schizophrenia (Tadokoro et al. 2007). Applying the Diagnosis and Statistical Manual of Mental Disorders to cases of EPS results in diagnoses of Bother specified mental disorder due to another medical condition^. However, the mechanism for generation of chronic psychosis with epilepsy subjects is unclear. Investigating the neural basis of EPS is an important research issue; however little examination has received to date. High resolution magnetic resonance imaging (MRI) is a suitable method for detecting subtle structur
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