Effects of menopause on brain structural changes in schizophrenia

Fukuta, Hajime; Ito, Itsuo; Tateno, Amane; Nogami, Tsuyoshi; Taiji, Yasutomo; Arakawa, Ryosuke; Suhara, Tetsuya; Asai, Kazuki; Okubo, Yoshiro

doi:10.1111/pcn.12003

Cited by 12 publications

(7 citation statements)

References 40 publications

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“…Using magnetic resonance imaging (MRI), Fukuta and coworkers 104 investigated the influences of menopause on brain morphological changes in 20 premenopausal and 20 postmenopausal women with schizophrenia (as well as 50 control women). The gray matter of postmenopausal patients was significantly smaller than that of premenopausal patients in the left middle frontal gyrus, suggesting an impact of estrogen loss on brain structure, which could explain the changes in positive symptoms 105 and cognitive symptoms.…”

Section: Hormones and Menopausementioning

confidence: 99%

The association between hormones and antipsychotic use: a focus on postpartum and menopausal women

González-Rodríguez

Seeman

2019

Therapeutic Advances in Psychopharmacology

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During the postpartum and menopausal periods of women’s lives, there is a well-established and significant drop of circulating estrogens. This may be the reason why both these periods are associated with an increased risk for onset or exacerbation of psychiatric disorders. Whether symptoms are mainly affective or mainly psychotic, these disorders are frequently treated with antipsychotic medications, which calls for an examination of the relationship between hormone replacement and antipsychotic agents at these time periods. The aim of this narrative review is to summarize what is known about the association of hormones and antipsychotics in the postnatal period and at menopause. In the review, we focus on estrogen and oxytocin hormones and include, for the most part, only papers published within the last 10 years. Both estradiol and oxytocin have at various times been implicated in the etiology of postpartum disorders, and estrogens, sometimes combined with progesterone, have been tested as potential treatments for these conditions. The role of estradiol as an adjunct to antipsychotics in the prevention of postpartum relapses is currently controversial. With respect to oxytocin, studies are lacking. Psychosis in menopausal and postmenopausal women has been successfully treated with estrogens and selective estrogen-receptor modulators, mainly raloxifene, in addition to antipsychotics. Some symptoms appear to respond better than others. No oxytocin study has specifically targeted postmenopausal women. Because of feedback mechanisms, there is a theoretical danger of therapy with exogenous hormones interfering with endogenous secretion and disturbing the balance among inter-related hormones. When used with antipsychotics, hormones may also affect the metabolism and, hence, the brain level of specific antipsychotics. This makes treatment with antipsychotics plus hormones complicated. Dose, timing and route of intervention may all prove critical to efficacy. While much remains unknown, this literature review indicates that, within standard dose ranges, the combination of hormones and antipsychotics for postnatal and menopausal women suffering severe mental distress can be beneficial, and is safe.

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Section: Hormones and Menopausementioning

confidence: 99%

The association between hormones and antipsychotic use: a focus on postpartum and menopausal women

González-Rodríguez

Seeman

2019

Therapeutic Advances in Psychopharmacology

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“…The superior parietal lobule has been reported to show significant changes in schizophrenia patients ( Yildiz et al, 2011 ). More recently, Fukuta et al's work showed that the gray matter in the left middle frontal gyrus presented significant change between postmenopausal patients and premenopausal patients ( Fukuta et al, 2013 ). This consistency with earlier findings further confirms the validity of our results.…”

Section: Discussionmentioning

confidence: 99%

Three dysconnectivity patterns in treatment-resistant schizophrenia patients and their unaffected siblings

Cao¹,

Liao²,

Liu³

et al. 2015

NeuroImage: Clinical

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Among individuals diagnosed with schizophrenia, approximately 20%–33% are recognized as treatment-resistant schizophrenia (TRS) patients. These TRS patients suffer more severely from the disease but struggle to benefit from existing antipsychotic treatments. A few recent studies suggested that schizophrenia may be caused by impaired synaptic plasticity that manifests as functional dysconnectivity in the brain, however, few of those studies focused on the functional connectivity changes in the brains of TRS groups. In this study, we compared the whole brain connectivity variations in TRS patients, their unaffected siblings, and healthy controls. Connectivity network features between and within the 116 automated anatomical labeling (AAL) brain regions were calculated and compared using maps created with three contrasts: patient vs. control, patient vs. sibling, and sibling vs. control. To evaluate the predictive power of the selected features, we performed a multivariate classification approach. We also evaluated the influence of six important clinical measures (e.g. age, education level) on the connectivity features. This study identified abnormal significant connectivity changes of three patterns in TRS patients and their unaffected siblings: 1) 69 patient-specific connectivity (PCN); 2) 102 shared connectivity (SCN); and 3) 457 unshared connectivity (UCN). While the first two patterns were widely reported by previous non-TRS specific studies, we were among the first to report widespread significant connectivity differences between TRS patient groups and their healthy sibling groups. Observations of this study may provide new insights for the understanding of the neurophysiological mechanisms of TRS.

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“…Others, however, found slight differences on cortical thickness (Luders et al, 2006;Plessen et al, 2014) or VBMmeasured asymmetries between male and female subjects (Good et al, 2001). Of note, to speculate that the post-menopausal state of the women included in our study may alter gender differences on brain structure and mitigate those differences (Eberling et al, 2004;Fukuta et al, 2013).…”

Section: Structural Asymmetriesmentioning

confidence: 96%

Structural laterality is associated with cognitive and mood outcomes: An assessment of 105 healthy aged volunteers

et al. 2017

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The human brain presents multiple asymmetries that dynamically change throughout life. These phenomena have been associated with cognitive impairments and psychiatric disorders although possible associations with specific patterns of cognitive aging are yet to be determined. We have therefore mapped and quantified morphological asymmetries in a heterogeneous and aged population (65.2±8.0 years old, 52 male and 53 female) to explore potential associations between the asymmetries in specific brain regions and cognitive performance. The sample was characterized in a battery of neuropsychological tests and in terms of brain structural asymmetries using a ROI-based approach. A substantial number of brain areas presented some degree of asymmetry. Such biases survived a stringent statistical correction and were largely confirmed in a voxel-based analysis. In specific brain areas, like the thalamus and insula, asymmetry was correlated with cognition and mood descriptors as the Stroop words/colors test or depressive mood scale, respectively. Curiously in the latter, the association was independent of its left/right direction. Altogether, results reveal that asymmetry is widespread in the aged brain and that area-specific biases (degree and direction) associate with the functional profile of the individual.

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Effects of menopause on brain structural changes in schizophrenia

Cited by 12 publications

References 40 publications

The association between hormones and antipsychotic use: a focus on postpartum and menopausal women

The association between hormones and antipsychotic use: a focus on postpartum and menopausal women

Three dysconnectivity patterns in treatment-resistant schizophrenia patients and their unaffected siblings

Structural laterality is associated with cognitive and mood outcomes: An assessment of 105 healthy aged volunteers

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