Publication: agnetic resonance imaging study of the amygdala-hippocampal complex and superior temporal gyrus in treatment-resistant schizophrenia and non- treatment-resistant schizophrenia - A pilot study
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Date
2022
Authors
Ahmad, Nur Shida
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Abstract
Background: Structural brain abnormalities is one of the leading cause of developing treatment-resistant schizophrenia. The main region affected is temporal lobes structures. Conventional magnetic resonance imaging has higher sensitivity, lacks ionising radiation and has been widely used in detecting structural brain abnormality. Because of the anatomic orientation of the temporal lobe, MRI findings are best identified by using a coronal oblique view. The purpose of this study is to compare the structure, signal intensity, and volumes of bilateral amygdala-hippocampal complex and superior temporal gyrus in treatment-resistant schizophrenia (TRS) and non-treatment-resistant schizophrenia (non-TRS) in this view. Methods: This prospective cohort study was conducted at Hospital Universiti Sains Malaysia (USM) on 30 patients, including 14 TRS patients and 16 non-TRS patients. These patients are subjected to an MRI brain study using epilepsy protocol. MR images were evaluated for loss of volume and abnormal signal intensity of bilateral amygdala-hippocampal complex (AHC) and superior temporal gyrus (STG) on T1- and T2-weighted images, as well as FLAIR images. The volumes of those structures are measured using Philips Intellispace Portal Software. Mean and standard deviations (SD) were obtained for each measurement, and the level of significance was determined (p-value < 0.05). The structure, signal intensity, and volumes of the bilateral amygdala-hippocampal complex and superior temporal gyrus for both groups were studied. Results: There was a significant mean difference in volumetric values between the groups of right AHC in the coronal plane (AHC COR) and right AHC in the axial plane (AHC AX) (p-value < 0.05). The mean and SD of right AHC COR in TRS patients is 25.3 cm3 (SD= 9.1 cm3) were higher than in Non-TRS patients, which is 18.8 cm (SD=5.4 cm3). The results also showed a high mean right AHC AX value in TRS patients, 29.0 cm3 (SD=11.1 cm3) compared to Non-TRS patients, 21.9 cm3 (SD=5.5 cm3). There were no significant mean differences of left AHC COR and AX between the patient groups (p-value > 0.05). The mean and SD of left AHC COR in TRS patients is 21.2 cm3 (SD=7.7 cm3) and Non-TRS patients is 16.6 cm3 (SD=6.4 cm3). The mean of left AHC AX in TRS patients is 25.0 cm3 (SD = 10.7 cm3) and Non-TRS patients is 20.4 cm3 (SD=5.1 cm3). There was no significant mean difference in volumetric values between the groups of bilateral STG in the coronal plane (STG COR) and sagittal plane (STG SAG) (p-value > 0.05). The mean and SD of right STG COR in TRS patients is 10.9 cm3 (SD=5.9 cm3) and Non-TRS patients is 12.0 cm3 (SD=3.0 cm3). The mean of left STG COR in TRS patients is 17.3 cm3 (SD=9.5 cm3) and Non-TRS patients is 14.4 cm3 (SD=2.4 cm3). The mean of right STG SAG in TRS patients is 14.8 cm3 (SD=3.6 cm3) and Non-TRS patients is 14.5 cm3 (SD=7.6 cm3). The mean of left STG SAG in TRS patients is 24.1 cm3 (SD=6.1 cm3) and Non-TRS patients is 16.2 cm3 (SD=5.4 cm3). There was no significant association between the brain structures, signal intensity, and group of patients (p-value < 0.05). The finding shows that the proportion of patients in TRS and Non-TRS patients was almost similar in terms of brain structure and diffusion. All patients were detected with no abnormal signal intensity. Conclusion: In conclusion, our findings show that TRS was associated with an increase in the mean volume of right AHC in both axial and coronal planes relative to non-TRS patients.
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Keywords
Treatment-resistant schizophrenia , amygdala-hippocampal complex