Late‐onset Psychosis with Agenesis of the Corpus Callosum

Abstract

Abstract:A 57-year-old woman showing her first psychiatric episode was admitted and MRI revealed agenesis of the corpus callosum with a lipoma. Except for the fact that her elder sister had been diagnosed with schizophrenia at the age of 24, she had no special anamnesis or problems in her life history. At the age of 57, troublesome behavior based on auditory hallucinations and delusions of persecution were noted which made it necessary for her to be taken to a hospital. There were no clinical signs of dementia, pathological reflexes or any other malfunctions. The brain MRI showed complete defect of the corpus callosum with a lipoma at the anterior midline region. According to characteristic findings of agenesis of the corpus callosum, parallel lateral ventricles, colpocephaly, and upward extension of the third ventricle were also noted. There were no findings of vascular change or cortical atrophy. Electroencephalography showed sharp waves and spikes appearing frequently in the parietal and occipital lobes. After being hospitalized, anti-psychotic drugs were effective against the symptoms which made it possible for her to be discharged after 8 weeks. She returned to her normal daily life and within 12 months there had been no signs of relapse and no considerable changes in MRI either. Although there have been many reports on schizophrenic patients with volumetric reduction of the corpus callosum, late-onset psychosis with callosal agenesis is quite rare. Neuroimaging investigations for lateonset psychosis are valuable to detect structural deficits or damages, and further cell-biological studies on commissural white matter are required to understand the correlations in pathogenesis between developmental failure and acquired brain damage.

The neuropsychology and neurobiology of late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: A critical review

“…Several studies looked into brain function and its association with late onset psychosis using EEG, ERP, positron emission tomography (PET) and single-photon emission computed tomography (SPECT). LOS subjects show a generalized slowing or a diffuse sharp and slow wave complex in their EEG [92][93][94][95], which points to changes in brain metabolism. These could only partially be explained by neuroleptic drug use.…”

Arnold-Chiari malformation and agenesis of the corpus callosum in a case of brief psychotic disorder

“…Volumetric decrease of the corpus callosum among schizophrenic patients is regarded as one of the reasons for cognitive dysfunction in the transfer of information between the two cerebral hemispheres. Schizophrenic patients with partial or complete agenesis of the corpus callosum, which is associated with neurodevelopmental abnormality, have been occasionally reported [7], as has delusional disorder with complete agenesis of the CC [14]. One review has suggested that abnormalities in the limbic structure developed along with corpus callosum agenesis may be linked to psychiatric disorder [15].…”

“…A number of magnetic resonance imaging (MRI) studies on the brains of patients with schizophrenia showed cortical and subcortical abnormalities, including in the corpus callosum. Reports of schizophrenic patients with partial or complete agenesis of the corpus callosum, which is associated with neurodevelopmental abnormalities, have occasionally been cited [7,8].…”