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Body mass index, residual psychotic symptoms, and inflammation associated with brain volume reduction in older patients with schizophrenia
Author(s) -
Tsai ShangYing,
Sajatovic Martha,
Hsu JungLung,
Chung KuoHsuan,
Chen PaoHuan,
Huang YuJui
Publication year - 2020
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5291
Subject(s) - white matter , grey matter , medicine , psychology , body mass index , positive and negative syndrome scale , orbitofrontal cortex , prefrontal cortex , magnetic resonance imaging , psychosis , psychiatry , radiology , cognition
Objective Obesity, aging, and pathophysiology of schizophrenia (SCZ) may collectively contribute to the gray matter loss in brain regions of SCZ. We attempted to examine the association between volumes of specific brain regions, body mass index (BMI), inflammatory markers, and clinical features in older SCZ patients. Method Clinically stable outpatients with schizophrenia (DSM‐IV) aged ≥50 years were recruited to undergo whole‐brain magnetic resonance imaging. We measured patients' plasma levels of soluble tumor necrosis factor receptor‐1, soluble interleukin (IL)‐2 receptor (sIL‐2R), IL‐1β, and IL‐1 receptor antagonist (IL‐1Ra). Clinical data were obtained from medical records and interviewing patients along with their reliable others. Results There were 32 patients with mean age 58.8 years in this study. Multivariate regression analysis found only higher BMI significantly associated with lower volume of total gray matter, bilateral orbitofrontal and prefrontal cortexes, and the right hippocampal and frontal cortexes. Increased intensity of residual symptoms (higher Positive and Negative Syndrome Scale scores) was related to lower volumes of frontal lobe, prefrontal cortex, insula, hippocampus, left hemisphere amygdala, and total white matter. The lower volume of left anterior cingulum was associated with older age and higher sIL‐2R plasma level; and higher IL‐1Ra level was associated with greater right anterior cingulate volume. Older age at illness onset was significantly associated with the smaller right insula volume. Conclusions Higher BMI, more residual symptoms, and inflammatory activity in IL‐2 and IL‐1 systems may play a role in gray matter loss in various brain regions of schizophrenia across the life span.