Regional brain volumes in brief psychotic disorder

A 30-year-old man with no significant previous or family psychiatric history became severely anxious about his health after a positive COVID-19 test. Physical symptoms of COVID-19 were mild, with no evidence of hypoxia or pneumonia, throughout his illness. He was admitted to a quarantine facility. He remained highly anxious, and 1 week later, he developed paranoid delusions and auditory hallucinations (his first psychotic episode). He was treated with lorazepam 1 mg four times a day, mirtazapine 30 mg nocte and risperidone 1 mg two times a day. His psychotic symptoms lasted 1 week. He stopped psychiatric medication after 4 weeks and had remained well when reviewed 3 months later. A Diagnostic and Statistical Manual of Mental Disorders fifth edition diagnosis of brief psychotic disorder with marked stressor (brief reactive psychosis) was made. Anxiety about his health and social isolation appeared the main aetiological factors but an inflammatory component cannot be excluded. The case highlights that first episode psychosis can be associated with mild COVID-19.

Download Full-text

Abstract 36: Association of Parental Stroke with Cognitive and Brain MRI Measures in Offspring - The Framingham Heart Study

Stroke ◽

10.1161/str.43.suppl_1.a36 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

GALIT WEINSTEIN ◽

Alexa Beiser ◽

Rhoda Au ◽

Charles DeCarli ◽

Philip A Wolf ◽

...

Keyword(s):

Executive Function ◽

Brain Injury ◽

Verbal Learning ◽

Brain Mri ◽

Abstract Reasoning ◽

Parental History ◽

Brain Volumes ◽

Regional Brain ◽

Increased Risk ◽

History Of

Objectives- Parental stroke is related to an increased risk of stroke among the offspring. Vascular related brain changes, however, often occur before clinical stroke and the association of parental history of stroke and structural brain measures and cognition has not been fully explored. We hypothesized that prospectively verified parental stroke will be associated with increased vascular brain injury and poorer cognitive performance. Methods- A total of 1,297 Framingham offspring (mean age: 61 ± 9 years, 54% women) were studied. Of these, 9.9% had prospectively identified stroke in one or both parents before age 65. Volumetric brain MRI measures of total cerebral brain volume (TCBV), regional brain volumes, white matter hyperintensity volume (WMHV), and covert brain infarcts (CBI) and performance on tests of verbal memory, abstract reasoning, verbal learning and visuospatial memory (VRd) were compared for offspring with and without parental history of stroke. All measures were assessed cross-sectionally and longitudinally (mean duration of follow-up was 6.1±1.2 years). We used models adjusted only for age, sex, education and also additionally adjusted for vascular risk factors and for WMHV as an index of subclinical vascular brain injury. GEE models were used to adjust for sibling relationships among offspring. Results- Higher WMHV (β±SE=0.17±0.08;p=0.027) and lower VRd scores (β±SE=-0.80±0.34; p=0.017) at baseline were found in offspring with parental history of stroke. In addition, participants with parental stroke by age 65 years were more likely to be in the highest quintile of increase in WMHV (OR=1.87;p=0.04) as well as worsening executive function (Trails B-A) (OR:1.81;p=0.03). Parental stroke was not associated with total and regional brain volumes or with memory, abstract reasoning and verbal learning. Conclusions- In our community-based sample of middle-aged asymptomatic subjects, the occurrence of parental stroke by age 65 years is associated with higher baseline WMHV and with a more rapid increase in WMHV. Further, parental stroke is also associated with poorer performance on VRd and a decline in executive function. The effects on baseline WMH and VRd were substantial equivalent to 2.8 and 7 years of brain aging, respectively.

Download Full-text

Brief psychotic disorder during COVID-19 infection: Marked stressor or neuropsychiatric symptoms?

Current Psychiatry Research and Reviews ◽

10.2174/2666082217666211007154908 ◽

2021 ◽

Vol 17 ◽

Author(s):

Jalal Doufik ◽

Said Boujraf ◽

Mina Ouhmou ◽

Hicham Laaraj ◽

Khalid Mouhadi ◽

...

Keyword(s):

Psychotic Disorder ◽

Neuropsychiatric Symptoms ◽

Stress Factor ◽

Positive Patient ◽

World Health ◽

Acute Psychosis ◽

Symptomatic Infection ◽

Brief Psychotic Disorder ◽

Coronavirus Infection ◽

Health Organization

Background: COVID-19 virus outbreak appeared in December 2019 and was announced as pandemic by the World Health Organization (WHO) in March 2020. Recent cases of reactive psychosis in the context of the COVID-19 pandemic have been reported. However, there was reduced interest attributed to cases of acute psychosis affecting patients with COVID-19. In here, we present a clinical case of a female patient who showed a brief psychotic disorder during a symptomatic infection with COVID-19. Methods: We discuss the differential diagnosis of brief psychotic disorder with marked stressor and neuropsychiatric symptoms of COVID-19 infection. Although the stress factor appeared to be linked to the acute psychosis onset in our COVID-19 positive patient, the diagnosis of a psychotic disorder due to the viral coronavirus infection is worthing to be reported and discussed. Results and Conclusion: The stress factor appears to be linked to the onset of acute psychosis in this COVID-19 positive patient, the diagnosis of a psychotic disorder due to the viral coronavirus infection is worth to be mentioned. Thus, we suggest that a new psychosis case associated with COVID-19 infection due to potential immune-mediated neuropathogenesis that would justify further investigation. Through this case report, we highlight the need for vigilant monitoring of neuropsychiatric symptoms in individuals with COVID-19 infections.

Download Full-text

Overview of Schizophrenia and Other Psychotic Disorders

10.2310/psych.13011 ◽

2020 ◽

Author(s):

James A. Wilcox ◽

Donald W. Black

Keyword(s):

Psychotic Disorder ◽

Schizoaffective Disorder ◽

Psychotic Disorders ◽

Public Health Problem ◽

Premature Death ◽

Major Public Health Problem ◽

Schizophreniform Disorder ◽

Schizophrenia Spectrum ◽

Brief Psychotic Disorder ◽

The Individual

Psychotic disorders are among the most disabling conditions and constitute a major public health problem. Described throughout recorded time, they affect as many as 5% of the population and cause a disproportionate amount of suffering and loss to society. In the chapter on schizophrenia spectrum and other psychotic disorders, the DSM-5 lists delusional disorder, brief psychotic disorder, schizophreniform disorder, schizophrenia, and schizoaffective disorder, as well as categories for substance- or medically induced psychotic disorders. The term psychosis indicates that the individual has a severe inability to interpret the surrounding environment in a realistic way. Symptoms include hallucinations, delusions, and bizarre behavior. Psychotic disorders are associated with premature death, mostly attributable to suicide. The pathophysiology and etiology of psychotic disorders are only now beginning to be understood, and treatment for these conditions remains suboptimal. Researchers are currently refining the cause of these symptoms and developing more effective treatments. This review contains 3 tables, and 34 references. Key words: Brief psychotic disorder, delusions, hallucinations, psychosis, schizoaffective disorder, schizophrenia, schizophreniform disorder

Download Full-text

Subclinical Agoraphobia Symptoms and Regional Brain Volumes in Non-clinical Subjects: Between Compensation and Resilience?

Frontiers in Psychiatry ◽

10.3389/fpsyt.2018.00541 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 5

Author(s):

Bianca Besteher ◽

Letizia Squarcina ◽

Robert Spalthoff ◽

Marcella Bellani ◽

Christian Gaser ◽

...

Keyword(s):

Brain Volumes ◽

Regional Brain

Download Full-text

Regional neurodegeneration correlates with sleep–wake dysfunction after stroke

SLEEP ◽

10.1093/sleep/zsaa054 ◽

2020 ◽

Vol 43 (9) ◽

Author(s):

Elie Gottlieb ◽

Natalia Egorova ◽

Mohamed S Khlif ◽

Wasim Khan ◽

Emilio Werden ◽

...

Keyword(s):

White Matter ◽

Sleep Duration ◽

A Priori ◽

Sleep Efficiency ◽

Poor Sleep ◽

Subcortical Structures ◽

Whole Brain ◽

Brain Volumes ◽

Regional Brain ◽

Long Sleep

Abstract Sleep–wake disruption is a key modifiable risk factor and sequela of stroke. The pathogenesis of poststroke sleep dysfunction is unclear. It is not known whether poststroke sleep pathology is due to focal infarction to sleep–wake hubs or to accelerated poststroke neurodegeneration in subcortical structures after stroke. We characterize the first prospective poststroke regional brain volumetric and whole-brain, fiber-specific, white matter markers of objectively measured sleep–wake dysfunction. We hypothesized that excessively long sleep (>8 h) duration and poor sleep efficiency (<80%) measured using the SenseWear Armband 3-months poststroke (n = 112) would be associated with reduced regional brain volumes of a priori-selected sleep–wake regions of interest when compared to healthy controls with optimal sleep characteristics (n = 35). We utilized a novel technique known as a whole-brain fixel-based analysis to investigate the fiber-specific white matter differences in participants with long sleep duration. Stroke participants with long sleep (n = 24) duration exhibited reduced regional volumes of the ipsilesional thalamus and contralesional amygdala when compared with controls. Poor sleep efficiency after stroke (n = 29) was associated with reduced ipsilesional thalamus, contralesional hippocampus, and contralesional amygdala volumes. Whole-brain fixel-based analyses revealed widespread macrostructural degeneration to the corticopontocerebellar tract in stroke participants with long sleep duration, with fiber reductions of up to 40%. Neurodegeneration to subcortical structures, which appear to be vulnerable to accelerated brain volume loss after stroke, may drive sleep–wake deficiencies poststroke, independent of lesion characteristics and confounding comorbidities. We discuss these findings in the context of the clinicopathological implications of sleep-related neurodegeneration and attempt to corroborate previous mechanistic-neuroanatomical findings.

Download Full-text

Regional brain volumes, microstructure and neurodevelopment in moderate–late preterm children

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2019-317941 ◽

2020 ◽

Vol 105 (6) ◽

pp. 593-599 ◽

Cited By ~ 1

Author(s):

Claire E Kelly ◽

Deanne K Thompson ◽

Alicia J Spittle ◽

Jian Chen ◽

Marc L Seal ◽

...

Keyword(s):

White Matter ◽

Grey Matter ◽

Diffusion Tensor ◽

Brain Mri ◽

Developmental Outcomes ◽

Late Preterm ◽

Brain Volumes ◽

Regional Brain ◽

White Matter Microstructure ◽

Cortical Grey Matter

ObjectiveTo explore whether regional brain volume and white matter microstructure at term-equivalent age (TEA) are associated with development at 2 years of age in children born moderate–late preterm (MLPT).Study designA cohort of MLPT infants had brain MRI at approximately TEA (38–44 weeks’ postmenstrual age) and had a developmental assessment (Bayley Scales of Infant and Toddler Development and Infant Toddler Social Emotional Assessment) at 2 years’ corrected age. Relationships between cortical grey matter and white matter volumes and 2-year developmental outcomes were explored using voxel-based morphometry. Relationships between diffusion tensor measures of white matter microstructure (fractional anisotropy (FA) and axial (AD), radial (RD) and mean (MD) diffusivities) and 2-year developmental outcomes were explored using tract-based spatial statistics.Results189 MLPT children had data from at least one MRI modality (volumetric or diffusion) and data for at least one developmental domain. Larger cortical grey and white matter volumes in many brain regions, and higher FA and lower AD, RD and MD in several major white matter regions, were associated with better cognitive and language scores. There was little evidence that cortical grey matter and white matter volumes and white matter microstructure were associated with motor and behavioural outcomes.ConclusionsRegional cortical grey matter and white matter volumes and white matter microstructure are associated with cognitive and language development at 2 years of age in MLPT children. Thus, early alterations to brain volumes and microstructure may contribute to some of the developmental deficits described in MLPT children.

Download Full-text