Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia

BMC Psychiatry

Research Article

Tomohisa Nagashima¹  Toshifumi Kishimoto¹  Kuniaki Kiuchi¹  Koji Okada¹  Naoko Kishimoto¹  Soichiro Kitamura¹  Makoto Inoue²  Jun Kosaka³  Kimihiko Kichikawa⁴  Toshiaki Taoka⁴ 

[1] Department of Psychiatry, Nara Medical University, Kashihara, Nara, Japan;Department of Psychiatry, Nara Medical University, Kashihara, Nara, Japan;National Hospital Organization Yamato Mental Medical Center, Yamatokoriyama, Nara, Japan;Department of Psychiatry, Nara Medical University, Kashihara, Nara, Japan;Sakai City Mental Health Center, Sakai, Osaka, Japan;Department of Radiology, Nara Medical University, Kashihara, Nara, Japan;

关键词: Schizophrenia;    Polydipsia;    Volumetry;    MRI;    Neuropsychological impairment;    Brief assessment of cognition in schizophrenia;   

DOI  :  10.1186/1471-244X-12-210

 received in 2012-02-16, accepted in 2012-11-21,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundPolydipsia frequently occurs in schizophrenia patients. The excessive water loading in polydipsia occasionally induces a hyponatremic state and leads to water intoxication. Whether polydipsia in schizophrenic patients correlates with neuropsychological impairments or structural brain changes is not clear and remains controversial.MethodsEight polydipsic schizophrenia patients, eight nonpolydipsic schizophrenia patients, and eight healthy controls were recruited. All subjects underwent magnetic resonance imaging (MRI) and neuropsychological testing. Structural abnormalities were analyzed using a voxel-based morphometry (VBM) approach, and patients’ neuropsychological function was assessed using the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J).ResultsNo significant differences were found between the two patient groups with respect to the clinical characteristics. Compared with healthy controls, polydipsic patients showed widespread brain volume reduction and neuropsychological impairment. Furthermore, the left insula was significantly reduced in polydipsic patients compared with nonpolydipsic patients. These nonpolydipsic patients performed intermediate to the other two groups in the neuropsychological function test.ConclusionsIt is possible that polydipsia or the secondary hyponatremia might induce left insula volume reduction. Furthermore, this structural brain change may indirectly induce more severe neuropsychological impairments in polydipsic patients. Thus, we suggest that insula abnormalities might contribute to the pathophysiology of polydipsic patients.

【 授权许可】

CC BY   
© Nagashima et al.; licensee BioMed Central Ltd. 2012