TY - JOUR
T1 - The relationship between stress, HPA axis functioning and brain structure in first episode psychosis over the first 12 weeks of treatment
AU - Reniers, Renate
AU - Garner, Belinda
AU - Phassouliotis, Christina
AU - Phillips, Lisa
AU - Markulev, Connie
AU - Pantelis, Christos
AU - Bendall, Sarah
AU - McGorry, Patrick
AU - Wood, Stephen
PY - 2015/2/28
Y1 - 2015/2/28
N2 - Stress and abnormal hypothalamic–pituitary–adrenal axis functioning have been implicated in the early phase of psychosis and may partly explain reported changes in brain structure. This study used magnetic resonance imaging to investigate whether biological measures of stress were related to brain structure at baseline and to structural changes over the first 12 weeks of treatment in first episode patients (n=22) compared with matched healthy controls (n=22). At baseline, no significant group differences in biological measures of stress, cortical thickness or hippocampal volume were observed, but a significantly stronger relationship between baseline levels of cortisol and smaller white matter volumes of the cuneus and anterior cingulate was found in patients compared with controls. Over the first 12 weeks of treatment, patients showed a significant reduction in thickness of the posterior cingulate compared with controls. Patients also showed a significant positive relationship between baseline cortisol and increases in hippocampal volume over time, suggestive of brain swelling in association with psychotic exacerbation, while no such relationship was observed in controls. The current findings provide some support for the involvement of stress mechanisms in the pathophysiology of early psychosis, but the changes are subtle and warrant further investigation.
AB - Stress and abnormal hypothalamic–pituitary–adrenal axis functioning have been implicated in the early phase of psychosis and may partly explain reported changes in brain structure. This study used magnetic resonance imaging to investigate whether biological measures of stress were related to brain structure at baseline and to structural changes over the first 12 weeks of treatment in first episode patients (n=22) compared with matched healthy controls (n=22). At baseline, no significant group differences in biological measures of stress, cortical thickness or hippocampal volume were observed, but a significantly stronger relationship between baseline levels of cortisol and smaller white matter volumes of the cuneus and anterior cingulate was found in patients compared with controls. Over the first 12 weeks of treatment, patients showed a significant reduction in thickness of the posterior cingulate compared with controls. Patients also showed a significant positive relationship between baseline cortisol and increases in hippocampal volume over time, suggestive of brain swelling in association with psychotic exacerbation, while no such relationship was observed in controls. The current findings provide some support for the involvement of stress mechanisms in the pathophysiology of early psychosis, but the changes are subtle and warrant further investigation.
KW - First episode psychosis
KW - Stress
KW - HPA axis
KW - cortical thickness
KW - hippocampal volume
KW - white matter volume
U2 - 10.1016/j.pscychresns.2014.11.004
DO - 10.1016/j.pscychresns.2014.11.004
M3 - Article
SN - 0925-4927
VL - 231
SP - 111
EP - 119
JO - Psychiatry Research Neuroimaging
JF - Psychiatry Research Neuroimaging
IS - 2
ER -