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Hibar DP, Westlye LT, Doan NT, Jahanshad N, Cheung JW, Ching CRK, Versace A, Bilderbeck AC, Uhlmann A, Mwangi B, Krämer B, Overs B, Hartberg CB, Abé C, Dima D, Grotegerd D, Sprooten E, Bøen E, Jimenez E, Howells FM, Delvecchio G, Temmingh H, Starke J, Almeida JRC, Goikolea JM, Houenou J, Beard LM, Rauer L, Abramovic L, Bonnin M, Ponteduro MF, Keil M, Rive MM, Yao N, Yalin N, Najt P, Rosa PG, Redlich R, Trost S, Hagenaars S, Fears SC, Alonso-Lana S, van Erp TGM, Nickson T, Chaim-Avancini TM, Meier TB, Elvsåshagen T, Haukvik UK, Lee WH, Schene AH, Lloyd AJ, Young AH, Nugent A, Dale AM, Pfennig A, McIntosh AM, Lafer B, Baune BT, Ekman CJ, Zarate CA, Bearden CE, Henry C, Simhandl C, McDonald C, Bourne C, Stein DJ, Wolf DH, Cannon DM, Glahn DC, Veltman DJ, Pomarol-Clotet E, Vieta E, Canales-Rodriguez EJ, Nery FG, Duran FLS, Busatto GF, Roberts G, Pearlson GD, Goodwin GM, Kugel H, Whalley HC, Ruhe HG, Soares JC, Fullerton JM, Rybakowski JK, Savitz J, Chaim KT, Fatjó-Vilas M, Soeiro-de-Souza MG, Boks MP, Zanetti MV, Otaduy MCG, Schaufelberger MS, Alda M, Ingvar M, Phillips ML, Kempton MJ, Bauer M, Landén M, Lawrence NS, van Haren NEM, Horn NR, Freimer NB, Gruber O, Schofield PR, Mitchell PB, Kahn RS, Lenroot R, Machado-Vieira R, Ophoff RA, Sarró S, Frangou S, Satterthwaite TD, Hajek T, Dannlowski U, Malt UF, Arolt V, Gattaz WF, Drevets WC, Caseras X, Agartz I, Thompson PM, Andreassen OA. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Mol Psychiatry 2018; 23:932-942. [PMID: 28461699 PMCID: PMC5668195 DOI: 10.1038/mp.2017.73] [Citation(s) in RCA: 422] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/04/2017] [Accepted: 02/10/2017] [Indexed: 12/13/2022]
Abstract
Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen's d=-0.293; P=1.71 × 10-21), left fusiform gyrus (d=-0.288; P=8.25 × 10-21) and left rostral middle frontal cortex (d=-0.276; P=2.99 × 10-19). Longer duration of illness (after accounting for age at the time of scanning) was associated with reduced cortical thickness in frontal, medial parietal and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD.
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Affiliation(s)
- D P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Janssen Research & Development, San Diego, CA, USA
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - N T Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - N Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - J W Cheung
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - C R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - A Versace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A C Bilderbeck
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - A Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - B Mwangi
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - B Overs
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - C B Hartberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Abé
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - D Dima
- Department of Psychology, City University London, London, UK,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster, Germany
| | - E Sprooten
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - E Jimenez
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - G Delvecchio
- IRCCS "E. Medea" Scientific Institute, San Vito al Tagliamento, Italy
| | - H Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J Starke
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J R C Almeida
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - J M Goikolea
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - J Houenou
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,NeuroSpin, UNIACT Lab, Psychiatry Team, CEA Saclay, Gif Sur Yvette, France
| | - L M Beard
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - L Rauer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - L Abramovic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Bonnin
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - M F Ponteduro
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Keil
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - M M Rive
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - N Yao
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - N Yalin
- Centre for Affective Disorders, King’s College London, London, UK
| | - P Najt
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - P G Rosa
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - S Trost
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - S Hagenaars
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S C Fears
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA,West Los Angeles Veterans Administration, Los Angeles, CA, USA
| | - S Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - T M Chaim-Avancini
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - T B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - T Elvsåshagen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - U K Haukvik
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Adult Psychiatry, University of Oslo, Oslo, Norway
| | - W H Lee
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - A J Lloyd
- Academic Psychiatry and Northern Centre for Mood Disorders, Newcastle University/Northumberland Tyne & Wear NHS Foundation Trust, Newcastle, UK
| | - A H Young
- Centre for Affective Disorders, King’s College London, London, UK
| | - A Nugent
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - A M Dale
- MMIL, Department of Radiology, University of California San Diego, San Diego, CA, USA,Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - A Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - B Lafer
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - B T Baune
- Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - C J Ekman
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - C A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - C E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - C Henry
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,Institut Pasteur, Unité Perception et Mémoire, Paris, France
| | - C Simhandl
- Bipolar Center Wiener Neustadt, Wiener Neustadt, Austria
| | - C McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C Bourne
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Department of Psychology & Counselling, Newman University, Birmingham, UK
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - D M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - D C Glahn
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - E Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - E Vieta
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - E J Canales-Rodriguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - F G Nery
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - F L S Duran
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G F Busatto
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G Roberts
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - G D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - G M Goodwin
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H G Ruhe
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J C Soares
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - J K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA,Faculty of Community Medicine, The University of Tulsa, Tulsa, OK, USA
| | - K T Chaim
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - M G Soeiro-de-Souza
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - M P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M V Zanetti
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M C G Otaduy
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M S Schaufelberger
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - M Ingvar
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - M L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M J Kempton
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Landén
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Goteborg, Sweden
| | - N S Lawrence
- Department of Psychology, University of Exeter, Exeter, UK
| | - N E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N R Horn
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - N B Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - P R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - P B Mitchell
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Lenroot
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - R Machado-Vieira
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - R A Ophoff
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - S Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - S Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - T Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,National Institute of Mental Health, Klecany, Czech Republic
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - U F Malt
- Division of Clinical Neuroscience, Department of Research and Education, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - W F Gattaz
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - W C Drevets
- Janssen Research & Development, Titusville, NJ, USA
| | - X Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - I Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - P M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - O A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,NORMENT, KG Jebsen Centre for Psychosis Research—TOP Study, Oslo University Hospital, Ullevål, Building 49, Kirkeveien 166, PO Box 4956, Nydalen, 0424, Oslo, Norway. E-mail:
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Lange EH, Nerland S, Jørgensen KN, Mørch-Johnsen L, Nesvåg R, Hartberg CB, Haukvik UK, Osnes K, Melle I, Andreassen OA, Agartz I. Alcohol use is associated with thinner cerebral cortex and larger ventricles in schizophrenia, bipolar disorder and healthy controls. Psychol Med 2017; 47:655-668. [PMID: 27830632 DOI: 10.1017/s0033291716002920] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Excessive alcohol use is associated with brain damage but less is known about brain effects from moderate alcohol use. Previous findings indicate that patients with severe mental illness, particularly schizophrenia, are vulnerable to alcohol-related brain damage. We investigated the association between levels of alcohol consumption and cortical and subcortical brain structures in schizophrenia and bipolar disorder patients and healthy controls, and investigated for group differences for this association. METHOD 1.5 T structural magnetic resonance images were acquired of 609 alcohol-using participants (165 schizophrenia patients, 172 bipolar disorder patients, 272 healthy controls), mean (s.d.) age 34.2 (9.9) years, 52% men. Past year alcohol use was assessed with the Alcohol Use Disorder Identification Test - Consumption part (AUDIT-C). General linear models were used to investigate associations between AUDIT-C score and cortical thickness, surface area, and total brain and subcortical volumes. RESULTS Increasing AUDIT-C score was linearly associated with thinner cortex in medial and dorsolateral frontal and parieto-occipital regions, and with larger left lateral ventricle volume. There was no significant interaction between AUDIT-C score and diagnostic group. The findings remained significant after controlling for substance use disorders, antipsychotic medication and illness severity. CONCLUSION The results show a dose-dependent relationship between alcohol use and thinner cortex and ventricular expansion. The findings are present also at lower levels of alcohol consumption and do not differ between schizophrenia or bipolar disorder patients compared to healthy controls. Our results do not support previous findings of increased vulnerability for alcohol-related brain damage in severe mental illness.
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Affiliation(s)
- E H Lange
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - S Nerland
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - K N Jørgensen
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - L Mørch-Johnsen
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - R Nesvåg
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - C B Hartberg
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - U K Haukvik
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - K Osnes
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - I Melle
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - O A Andreassen
- NORMENT and K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - I Agartz
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
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3
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Jørgensen KN, Nesvåg R, Nerland S, Mørch-Johnsen L, Westlye LT, Lange EH, Haukvik UK, Hartberg CB, Melle I, Andreassen OA, Agartz I. Brain volume change in first-episode psychosis: an effect of antipsychotic medication independent of BMI change. Acta Psychiatr Scand 2017; 135:117-126. [PMID: 27925164 DOI: 10.1111/acps.12677] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The effect of antipsychotic medication on brain structure remains unclear. Given the prevalence of weight gain as a side-effect, body mass index (BMI) change could be a confounder. METHOD Patients with first-episode psychosis (n = 78) and healthy controls (n = 119) underwent two 1.5T MRI scans with a 1-year follow-up interval. siena (fsl 5.0) was used to measure whole-brain volume change. Weight and height were measured at both time points. Antipsychotic medication use at baseline and follow-up was converted into chlorpromazine equivalent dose and averaged. RESULTS Patients did not show significantly larger brain volume loss compared with healthy controls. In the whole sample (n = 197), BMI change was negatively associated with brain volume change (β = -0.19, P = 0.008); there was no interaction effect of group. Among patients, higher antipsychotic medication dosage was associated with greater brain volume loss (β = -0.45, P < 0.001). This association was not affected by adjusting for BMI change. CONCLUSION Weight gain was related to brain volume reductions to a similar degree among patients and controls. Antipsychotic dosage-related reductions of brain volume were not confounded by BMI change. Generalizability to contexts involving severe weight gain needs to be established. Furthermore, disentangling effects of medication from illness severity remains a challenge.
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Affiliation(s)
- K N Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - R Nesvåg
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - S Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - L Mørch-Johnsen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L T Westlye
- NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - E H Lange
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - U K Haukvik
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C B Hartberg
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - I Melle
- NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - O A Andreassen
- NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - I Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,NORMENT and K.G. Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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4
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Hibar DP, Westlye LT, van Erp TGM, Rasmussen J, Leonardo CD, Faskowitz J, Haukvik UK, Hartberg CB, Doan NT, Agartz I, Dale AM, Gruber O, Krämer B, Trost S, Liberg B, Abé C, Ekman CJ, Ingvar M, Landén M, Fears SC, Freimer NB, Bearden CE, Sprooten E, Glahn DC, Pearlson GD, Emsell L, Kenney J, Scanlon C, McDonald C, Cannon DM, Almeida J, Versace A, Caseras X, Lawrence NS, Phillips ML, Dima D, Delvecchio G, Frangou S, Satterthwaite TD, Wolf D, Houenou J, Henry C, Malt UF, Bøen E, Elvsåshagen T, Young AH, Lloyd AJ, Goodwin GM, Mackay CE, Bourne C, Bilderbeck A, Abramovic L, Boks MP, van Haren NEM, Ophoff RA, Kahn RS, Bauer M, Pfennig A, Alda M, Hajek T, Mwangi B, Soares JC, Nickson T, Dimitrova R, Sussmann JE, Hagenaars S, Whalley HC, McIntosh AM, Thompson PM, Andreassen OA. Subcortical volumetric abnormalities in bipolar disorder. Mol Psychiatry 2016; 21:1710-1716. [PMID: 26857596 PMCID: PMC5116479 DOI: 10.1038/mp.2015.227] [Citation(s) in RCA: 310] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/08/2015] [Accepted: 12/11/2015] [Indexed: 11/29/2022]
Abstract
Considerable uncertainty exists about the defining brain changes associated with bipolar disorder (BD). Understanding and quantifying the sources of uncertainty can help generate novel clinical hypotheses about etiology and assist in the development of biomarkers for indexing disease progression and prognosis. Here we were interested in quantifying case-control differences in intracranial volume (ICV) and each of eight subcortical brain measures: nucleus accumbens, amygdala, caudate, hippocampus, globus pallidus, putamen, thalamus, lateral ventricles. In a large study of 1710 BD patients and 2594 healthy controls, we found consistent volumetric reductions in BD patients for mean hippocampus (Cohen's d=-0.232; P=3.50 × 10-7) and thalamus (d=-0.148; P=4.27 × 10-3) and enlarged lateral ventricles (d=-0.260; P=3.93 × 10-5) in patients. No significant effect of age at illness onset was detected. Stratifying patients based on clinical subtype (BD type I or type II) revealed that BDI patients had significantly larger lateral ventricles and smaller hippocampus and amygdala than controls. However, when comparing BDI and BDII patients directly, we did not detect any significant differences in brain volume. This likely represents similar etiology between BD subtype classifications. Exploratory analyses revealed significantly larger thalamic volumes in patients taking lithium compared with patients not taking lithium. We detected no significant differences between BDII patients and controls in the largest such comparison to date. Findings in this study should be interpreted with caution and with careful consideration of the limitations inherent to meta-analyzed neuroimaging comparisons.
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Affiliation(s)
- D P Hibar
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
| | - L T Westlye
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - J Rasmussen
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - C D Leonardo
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
| | - J Faskowitz
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
| | - U K Haukvik
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - C B Hartberg
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
| | - N T Doan
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
| | - I Agartz
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - A M Dale
- MMIL, Department of Radiology, University of California, San Diego, CA, USA
- Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, CA, USA
| | - O Gruber
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, Georg August University Goettingen, Goettingen, Germany
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B Krämer
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, Georg August University Goettingen, Goettingen, Germany
| | - S Trost
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, Georg August University Goettingen, Goettingen, Germany
| | - B Liberg
- Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - C Abé
- Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - C J Ekman
- Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - M Ingvar
- Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
- Karolinska MR Research Center, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - M Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - S C Fears
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA, USA
| | - N B Freimer
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA, USA
| | - C E Bearden
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - the Costa Rica/Colombia Consortium for Genetic Investigation of Bipolar Endophenotypes
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- MMIL, Department of Radiology, University of California, San Diego, CA, USA
- Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, CA, USA
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, Georg August University Goettingen, Goettingen, Germany
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
- Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institutet, Stockholm, Sweden
- Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
- Karolinska MR Research Center, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
- Department of Psychiatry, Brown University, Providence, RI, USA
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- School of Psychology, University of Exeter, Exeter, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Neurospin, Uniact, I2BM, CEA Saclay, Saclay, France
- Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France
- Université Paris-Est, UMR-S955, UPEC, Créteil, France
- Department of Psychosomatic Medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Research and Education, Oslo University Hospital, Oslo, Norway
- Norwegian Research Network On Mood Disorders, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- Centre for Affective Disorders, King's College London, London, UK
- Academic Psychiatry and Regional Affective Disorders Service, Newcastle University, Newcastle, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychology and Counselling, Newman University, Birmingham, UK
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK
- Department of Psychiatry, University Medical Centre Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- National Institute of Mental Health, Klecany, Czech Republic
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, UT Houston Medical School, Houston, TX, USA
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - E Sprooten
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
| | - D C Glahn
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
| | - G D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA
| | - L Emsell
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - J Kenney
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C Scanlon
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C McDonald
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - D M Cannon
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - J Almeida
- Department of Psychiatry, Brown University, Providence, RI, USA
| | - A Versace
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - X Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - N S Lawrence
- School of Psychology, University of Exeter, Exeter, UK
| | - M L Phillips
- MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - D Dima
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Delvecchio
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D Wolf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J Houenou
- Neurospin, Uniact, I2BM, CEA Saclay, Saclay, France
- Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France
| | - C Henry
- Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France
- Université Paris-Est, UMR-S955, UPEC, Créteil, France
| | - U F Malt
- Department of Psychosomatic Medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Research and Education, Oslo University Hospital, Oslo, Norway
| | - E Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychosomatic Medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Research Network On Mood Disorders, Oslo, Norway
| | - T Elvsåshagen
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
- Department of Psychosomatic Medicine, Oslo University Hospital—Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - A H Young
- Centre for Affective Disorders, King's College London, London, UK
| | - A J Lloyd
- Academic Psychiatry and Regional Affective Disorders Service, Newcastle University, Newcastle, UK
| | - G M Goodwin
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - C E Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - C Bourne
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychology and Counselling, Newman University, Birmingham, UK
| | - A Bilderbeck
- Department of Psychiatry, University of Oxford, Oxford, UK
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK
| | - L Abramovic
- Department of Psychiatry, University Medical Centre Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - M P Boks
- Department of Psychiatry, University Medical Centre Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - N E M van Haren
- Department of Psychiatry, University Medical Centre Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - R A Ophoff
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA, USA
- Department of Psychiatry, University Medical Centre Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - R S Kahn
- Department of Psychiatry, University Medical Centre Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - M Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - A Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - T Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - B Mwangi
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, UT Houston Medical School, Houston, TX, USA
| | - J C Soares
- UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, UT Houston Medical School, Houston, TX, USA
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - R Dimitrova
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - J E Sussmann
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S Hagenaars
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - P M Thompson
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - O A Andreassen
- Division of Mental Health and Addiction, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
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5
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van Erp TGM, Hibar DP, Rasmussen JM, Glahn DC, Pearlson GD, Andreassen OA, Agartz I, Westlye LT, Haukvik UK, Dale AM, Melle I, Hartberg CB, Gruber O, Kraemer B, Zilles D, Donohoe G, Kelly S, McDonald C, Morris DW, Cannon DM, Corvin A, Machielsen MWJ, Koenders L, de Haan L, Veltman DJ, Satterthwaite TD, Wolf DH, Gur RC, Gur RE, Potkin SG, Mathalon DH, Mueller BA, Preda A, Macciardi F, Ehrlich S, Walton E, Hass J, Calhoun VD, Bockholt HJ, Sponheim SR, Shoemaker JM, van Haren NEM, Pol HEH, Ophoff RA, Kahn RS, Roiz-Santiañez R, Crespo-Facorro B, Wang L, Alpert KI, Jönsson EG, Dimitrova R, Bois C, Whalley HC, McIntosh AM, Lawrie SM, Hashimoto R, Thompson PM, Turner JA. Subcortical brain volume abnormalities in 2028 individuals with schizophrenia and 2540 healthy controls via the ENIGMA consortium. Mol Psychiatry 2016; 21:547-53. [PMID: 26033243 PMCID: PMC4668237 DOI: 10.1038/mp.2015.63] [Citation(s) in RCA: 596] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 03/05/2015] [Accepted: 03/18/2015] [Indexed: 12/17/2022]
Abstract
The profile of brain structural abnormalities in schizophrenia is still not fully understood, despite decades of research using brain scans. To validate a prospective meta-analysis approach to analyzing multicenter neuroimaging data, we analyzed brain MRI scans from 2028 schizophrenia patients and 2540 healthy controls, assessed with standardized methods at 15 centers worldwide. We identified subcortical brain volumes that differentiated patients from controls, and ranked them according to their effect sizes. Compared with healthy controls, patients with schizophrenia had smaller hippocampus (Cohen's d=-0.46), amygdala (d=-0.31), thalamus (d=-0.31), accumbens (d=-0.25) and intracranial volumes (d=-0.12), as well as larger pallidum (d=0.21) and lateral ventricle volumes (d=0.37). Putamen and pallidum volume augmentations were positively associated with duration of illness and hippocampal deficits scaled with the proportion of unmedicated patients. Worldwide cooperative analyses of brain imaging data support a profile of subcortical abnormalities in schizophrenia, which is consistent with that based on traditional meta-analytic approaches. This first ENIGMA Schizophrenia Working Group study validates that collaborative data analyses can readily be used across brain phenotypes and disorders and encourages analysis and data sharing efforts to further our understanding of severe mental illness.
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Affiliation(s)
- T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D P Hibar
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
| | - J M Rasmussen
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D C Glahn
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
| | - G D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford, CT, USA
| | - O A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - I Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - L T Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - U K Haukvik
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - A M Dale
- MMIL, Department of Radiology, University of California, San Diego, CA, USA
- Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, CA, USA
| | - I Melle
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - C B Hartberg
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - O Gruber
- Department of Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - B Kraemer
- Department of Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - D Zilles
- Department of Psychiatry, University Medical Center Göttingen, Göttingen, Germany
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, Georg August University, Göttingen, Germany
| | - G Donohoe
- Cognitive Genetics and Therapy Group, School of Psychology, National University of Ireland, Galway, Ireland
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - S Kelly
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - C McDonald
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - D W Morris
- Cognitive Genetics and Therapy Group, School of Psychology, National University of Ireland, Galway, Ireland
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - D M Cannon
- Clinical Neuroimaging Laboratory, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - A Corvin
- Neuropsychiatric Genetics research group, Department of Psychiatry and Trinity College Institute of Psychiatry, Trinity College, Dublin, Ireland
| | - M W J Machielsen
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - L Koenders
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - L de Haan
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - D J Veltman
- University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - S G Potkin
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D H Mathalon
- Department of Psychiatry, University of California, San Francisco, CA, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - B A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - A Preda
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - F Macciardi
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - S Ehrlich
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Technische Universität, Dresden, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - E Walton
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Technische Universität, Dresden, Germany
| | - J Hass
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Technische Universität, Dresden, Germany
| | - V D Calhoun
- Mind Research Network, Albuquerque, NM, USA
- Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - H J Bockholt
- Mind Research Network, Albuquerque, NM, USA
- Advanced Biomedical Informatics Group, LLC, Iowa City, IA, USA
- The University of Iowa, Iowa City, IA, USA
| | - S R Sponheim
- Minneapolis VA Healthcare System & Department of Psychiatry, University of Minnesota, Twin Cities, MN, USA
| | | | - N E M van Haren
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H E H Pol
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R A Ophoff
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Center for Neurobehavioral Genetics, University of California, Los Angeles, CA, USA
| | - R S Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Roiz-Santiañez
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - B Crespo-Facorro
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria-IDIVAL, Santander, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - L Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
- Department of Radiology, Northwestern University Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - K I Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - E G Jönsson
- Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R Dimitrova
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - C Bois
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - S M Lawrie
- Division of Psychiatry, University of Edinburgh Medical School, Edinburgh, UK
| | - R Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - P M Thompson
- Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA
| | - J A Turner
- Mind Research Network, Albuquerque, NM, USA
- Departments of Psychology and Neuroscience, Georgia State University, Atlanta, GA, USA
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van Erp TGM, Hibar DP, Rasmussen JM, Glahn DC, Pearlson GD, Andreassen OA, Agartz I, Westlye LT, Haukvik UK, Dale AM, Melle I, Hartberg CB, Gruber O, Kraemer B, Zilles D, Donohoe G, Kelly S, McDonald C, Morris DW, Cannon DM, Corvin A, Machielsen MWJ, Koenders L, de Haan L, Veltman DJ, Satterthwaite TD, Wolf DH, Gur RC, Gur RE, Potkin SG, Mathalon DH, Mueller BA, Preda A, Macciardi F, Ehrlich S, Walton E, Hass J, Calhoun VD, Bockholt HJ, Sponheim SR, Shoemaker JM, van Haren NEM, Pol HEH, Ophoff RA, Kahn RS, Roiz-Santiañez R, Crespo-Facorro B, Wang L, Alpert KI, Jönsson EG, Dimitrova R, Bois C, Whalley HC, McIntosh AM, Lawrie SM, Hashimoto R, Thompson PM. Subcortical brain volume abnormalities in 2028 individuals with schizophrenia and 2540 healthy controls via the ENIGMA consortium. Mol Psychiatry 2016; 21:585. [PMID: 26283641 PMCID: PMC5751698 DOI: 10.1038/mp.2015.118] [Citation(s) in RCA: 181] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Haukvik UK, Hartberg CB, Nerland S, Jørgensen KN, Lange EH, Simonsen C, Nesvåg R, Dale AM, Andreassen OA, Melle I, Agartz I. No progressive brain changes during a 1-year follow-up of patients with first-episode psychosis. Psychol Med 2016; 46:589-598. [PMID: 26526001 DOI: 10.1017/s003329171500210x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND First-episode psychosis (FEP) patients show structural brain abnormalities. Whether the changes are progressive or not remain under debate, and the results from longitudinal magnetic resonance imaging (MRI) studies are mixed. We investigated if FEP patients showed a different pattern of regional brain structural change over a 1-year period compared with healthy controls, and if putative changes correlated with clinical characteristics and outcome. METHOD MRIs of 79 FEP patients [SCID-I-verified diagnoses: schizophrenia, psychotic bipolar disorder, or other psychoses, mean age 27.6 (s.d. = 7.7) years, 66% male] and 82 healthy controls [age 29.3 (s.d. = 7.2) years, 66% male] were acquired from the same 1.5 T scanner at baseline and 1-year follow-up as part of the Thematically Organized Psychosis (TOP) study, Oslo, Norway. Scans were automatically processed with the longitudinal stream in FreeSurfer that creates an unbiased within-subject template image. General linear models were used to analyse longitudinal change in a wide range of subcortical volumes and detailed thickness and surface area estimates across the entire cortex, and associations with clinical characteristics. RESULTS FEP patients and controls did not differ significantly in annual percentage change in cortical thickness or area in any cortical region, or in any of the subcortical structures after adjustment for multiple comparisons. Within the FEP group, duration of untreated psychosis, age at illness onset, antipsychotic medication use and remission at follow-up were not related to longitudinal brain change. CONCLUSIONS We found no significant longitudinal brain changes over a 1-year period in FEP patients. Our results do not support early progressive brain changes in psychotic disorders.
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Affiliation(s)
- U K Haukvik
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - C B Hartberg
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - S Nerland
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - K N Jørgensen
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - E H Lange
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - C Simonsen
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - R Nesvåg
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - A M Dale
- NORMENT and K.G. Jebsen Centre for Psychosis Research,Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - O A Andreassen
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - I Melle
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
| | - I Agartz
- NORMENT K.G. Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,Oslo,Norway
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Haukvik UK, Schaer M, Nesvåg R, McNeil T, Hartberg CB, Jönsson EG, Eliez S, Agartz I. Cortical folding in Broca's area relates to obstetric complications in schizophrenia patients and healthy controls. Psychol Med 2012; 42:1329-1337. [PMID: 22029970 DOI: 10.1017/s0033291711002315] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The increased occurrence of obstetric complications (OCs) in patients with schizophrenia suggests that alterations in neurodevelopment may be of importance to the aetiology of the illness. Abnormal cortical folding may reflect subtle deviation from normal neurodevelopment during the foetal or neonatal period. In the present study, we hypothesized that OCs would be related to cortical folding abnormalities in schizophrenia patients corresponding to areas where patients with schizophrenia display altered cortical folding when compared with healthy controls. METHOD In total, 54 schizophrenia patients and 54 healthy control subjects underwent clinical examination and magnetic resonance image scanning on a 1.5 T scanner. Information on OCs was collected from original birth records. An automated algorithm was used to calculate a three-dimensional local gyrification index (lGI) at numerous points across the cortical mantle. RESULTS In both schizophrenia patients and healthy controls, an increasing number of OCs was significantly related to lower lGI in the left pars triangularis (p<0.0005) in Broca's area. For five other anatomical cortical parcellations in the left hemisphere, a similar trend was demonstrated. No significant relationships between OCs and lGI were found in the right hemisphere and there were no significant case-control differences in lGI. CONCLUSIONS The reduced cortical folding in the left pars triangularis, associated with OCs in both patients and control subjects suggests that the cortical effect of OCs is caused by factors shared by schizophrenia patients and healthy controls rather than factors related to schizophrenia alone.
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Affiliation(s)
- U K Haukvik
- Department of Clinical Medicine, section Vinderen, University of Oslo, Oslo, Norway.
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