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. 2013 Dec 27;4:232-9.
doi: 10.1016/j.nicl.2013.12.007. eCollection 2014.

Ventral Striatum Gray Matter Density Reduction in Patients With Schizophrenia and Psychotic Emotional Dysregulation

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Free PMC article

Ventral Striatum Gray Matter Density Reduction in Patients With Schizophrenia and Psychotic Emotional Dysregulation

Katharina Stegmayer et al. Neuroimage Clin. .
Free PMC article

Abstract

Introduction: Substantial heterogeneity remains across studies investigating changes in gray matter in schizophrenia. Differences in methodology, heterogeneous symptom patterns and symptom trajectories may contribute to inconsistent findings. To address this problem, we recently proposed to group patients by symptom dimensions, which map on the language, the limbic and the motor systems. The aim of the present study was to investigate whether patients with prevalent symptoms of emotional dysregulation would show structural neuronal abnormalities in the limbic system.

Method: 43 right-handed medicated patients with schizophrenia were assessed with the Bern Psychopathology Scale (BPS). The patients and a control group of 34 healthy individuals underwent structural imaging at a 3T MRI scanner. Whole brain voxel-based morphometry (VBM) was compared between patient subgroups with different severity of emotional dysregulation. Group comparisons (comparison between patients with severe emotional dysregulation, patients with mild emotional dysregulation, patients with no emotional dysregulation and healthy controls) were performed using a one way ANOVA and ANCOVA respectively.

Results: Patients with severe emotional dysregulation had significantly decreased gray matter density in a large cluster including the right ventral striatum and the head of the caudate compared to patients without emotional dysregulation. Comparing patients with severe emotional dysregulation and healthy controls, several clusters of significant decreased GM density were detected in patients, including the right ventral striatum, head of the caudate, left hippocampus, bilateral thalamus, dorsolateral prefrontal and orbitofrontal cortex. The significant effect in the ventral striatum was lost when patients with and without emotional dysregulation were pooled and compared with controls.

Discussion: Decreased gray matter density in a large cluster including the right ventral striatum was associated with severe symptoms of emotional dysregulation in patients with schizophrenia. The ventral striatum is an important part of the limbic system, and was indicated to be involved in the generation of incentive salience and psychotic symptoms. Only patients with severe emotional dysregulation had decreased gray matter in several brain structures associated with emotion and reward processing compared to healthy controls. The results support the hypothesis that grouping patients according to specific clinical symptoms matched to the limbic system allows identifying patient subgroups with structural abnormalities in the limbic network.

Keywords: Brain circuits; Dimensions; Emotional dysregulation; Limbic system; Psychopathology.

Figures

Fig. 1
Fig. 1
Decreased GM density of the ventral striatum of patients with severe emotional dysregulation. Group map of volumes with lower concentration of GM was statistically thresholded at p < 0.001, uncorrected and displayed on the section of the standard MNI-template; minimum cluster size threshold of 17 voxels. Local difference maxima in the depicted brain region reached a peak p-value of 0.046, FDR-corrected. GM density values in the cluster including the right ventral striatum of patients with severe and no emotional dysregulation. sED: severe emotional dysregulation and nED: no emotional dysregulation.
Fig. 2
Fig. 2
Decreased GM density in patients with severe emotional dysregulation compared to healthy controls. Group map of volumes with lower concentration of GM was statistically thresholded at p < 0.001, uncorrected and displayed on the section of the standard MNI brain; minimum cluster size threshold of 17 voxels.
Fig. 3
Fig. 3
Decreased GM density of all patients compared to healthy controls. Group map of volumes with lower concentration of GM was statistically thresholded at p < 0.001, uncorrected and displayed on the section of the standard MNI brain; minimum cluster size threshold of 17 voxels.

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