Gray Matter Abnormalities in Schizophrenia Patients with Tardive Dyskinesia: A Magnetic Resonance Imaging Voxel-Based Morphometry Study

Abstract

ObjectiveThe pathophysiological mechanism of TD remains unknown. All previous studies, using the region-of-interest method, focused on basal ganglion areas, were with inconsistent results. This whole-brain voxel-based morphometry (VBM) study investigate the grey matter abnormality of TD and its correlates with clinical ratings.MethodHigh resolution T1-weighted brain volumetric MRI from 25 schizophrenia patients with TD (TD group), 25 age-, gender-, and handedness-matched schizophrenia patients without TD (non-TD group), and 25 matched healthy subjects (NC group) were analyzed using a VBM approach. Clinical ratings included the Positive and Negative Symptom Scale (PANSS), Abnormal Involuntary Movement Scale (AIMS), and the Simpson-Angus Scale (SAS).ResultsThe TD group had significantly smaller total gray matter volumes than the NC group (p = 0.05). Compared to the non-TD group, the TD group had significantly higher PANSS negative (p<0.001), SAS (p<0.001), and AIMS (p<0.001) scores; and smaller bilateral inferior frontal gyrus, which correlated negatively with the PANSS negative scores (r = −0.366, p<0.05); and smaller right superior frontal gyrus, which correlated negatively with AIMS scores (r = −0.399, p<0.001), and PANSS general score (r = −0.338, p<0.05).LimitationsThe cross-section design can’t separate the gray matter change to TD from the context of the illness of schizophrenia, although TD with more severe clinical psychopathology could be a phenotype.ConclusionsThe schizophrenia patients with TD had significantly reduced gray matter, mostly at the bilateral inferior frontal gyrus and the right superior frontal gyrus, which correlated with severity of clinical symptoms and involuntary movement, respectively.

Psychomotor symptoms of schizophrenia map on the cerebral motor circuit

“…Gray matter was reduced in patients with dyskinesia compared with patients without dyskinesia in the inferior frontal gyrus bilaterally and in the right superior frontal gyrus. This reduction in volume was correlated with dyskinesia severity (Li et al, 2013). Likewise, a DTI study in patients with schizophrenia and tardive dyskinesia reported lower fractional anisotropy (FA) in white matter surrounding the inferior frontal gyrus, the basal ganglia, the dorsolateral prefrontal cortex, and the somatosensory cortex.…”

Metabolic syndrome and adverse clinical outcomes in patients with bipolar disorder

“…Furthermore, the potent antioxidants vitamins E and B6 as well as piracetam have been shown to alleviate the severity of tardive dyskinesia in randomized, double-blind, placebo-controlled studies [62, 63]. In addition, the severity of tardive dyskinesia is positively associated with that of cognitive dysfunction [64–66], significantly reduced gray matter, and widespread abnormality of white matter over corticobasal ganglion circuits, which involves emotional and behavioral regulation as well as executive function [67, 68]. Taken together, these studies further support our results that patients with MetS have severer tardive dyskinesia and are characterized by severer neurodegeneration and poorer clinical outcomes.…”

A comparison study of metabolic profiles, immunity, and brain gray matter volumes between patients with bipolar disorder and depressive disorder

“…The warped modulated images of gray matter were smoothened through the convolution of an 8-mm full-width, at half-maximum isotropic Gaussian kernel before tissue volume calculation and voxel-wise group comparisons. The total intracranial volume (TIV) was determined as the sum of GM, WM, and CSF volumes [33,34].…”