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Year : 2014  |  Volume : 35  |  Issue : 1  |  Page : 1-13

Caudate nucleus volume in schizophrenia, bipolar, and depressive psychosis

1 Department of Psychiatry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
2 Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
3 Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
4 FRCR, Department of MRI, Hadi Hospital, Kuwait

Correspondence Address:
Maha ELTayebani
Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-1105.127264

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Introduction The 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 CN size and its clinical, cognitive correlates in drug-naive patients with first-episode psychosis. 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 and finally, the Simpson-Angus Scale for extrapyramidal Parkinson features. Results (i) CN size was significantly more reduced in bipolar patients than in healthy controls with 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 CN volume reduction in bipolar psychotic patients may reflect part of the pathophysiology of 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.

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