PMID- 25610781
OWN - NLM
STAT- MEDLINE
DCOM- 20150924
LR  - 20181113
IS  - 2213-1582 (Electronic)
IS  - 2213-1582 (Linking)
VI  - 7
DP  - 2015
TI  - Reduced hippocampal volume and hypothalamus-pituitary-adrenal axis function in 
      first episode psychosis: evidence for sex differences.
PG  - 195-202
LID - 10.1016/j.nicl.2014.12.001 [doi]
AB  - BACKGROUND: Hippocampal volume (HV) decline is an important marker of psychosis 
      and has been associated with hypothalamus-pituitary-adrenal (HPA) axis 
      dysregulation in various disorders. Given recent findings of sex differences in 
      HPA axis function in psychosis, the current study investigated differences in HV 
      in male and female first episode psychosis (FEP) patients and controls and the 
      interaction of HV with the cortisol awakening response (CAR) and symptoms. 
      METHODS: Fifty-eight patients with a diagnosis of FEP (39 men, 19 women) and 27 
      healthy community controls (15 men, 12 women) underwent structural magnetic 
      resonance imaging (MRI) on a 1.5 T scanner. Hippocampal volume was determined 
      using previously established segmentation protocols. Saliva samples for cortisol 
      assessment were collected at 0, 30 and 60 min after awakening. Psychotic symptoms 
      were assessed with the Scale for Assessment of Positive Symptoms (SAPS), the 
      Scale for Assessment of Negative Symptoms (SANS) and the Global Assessment of 
      Functioning (GAF) scale. RESULTS: Male patients had significantly smaller left 
      and right HVs compared to male controls, which appeared to be secondary to global 
      brain volume differences. However, even when controlling for overall brain size, 
      male patients showed smaller HV compared to female patients. The CAR was 
      significantly lower in male patients compared to male controls and female 
      patients. Only in male patients, smaller left HV was significantly associated 
      with a blunted CAR, and smaller HV bilaterally was related to positive psychotic 
      symptoms and lower levels of functioning. CONCLUSIONS: We propose that reduced 
      hippocampal volume and an attenuated cortisol awakening response are related 
      markers of increased stress vulnerability in male psychosis patients and that 
      both contribute to the unfavorable clinical picture in men.
FAU - Pruessner, Marita
AU  - Pruessner M
AD  - Department of Psychiatry, Prevention and Early Intervention Program for 
      Psychosis, Douglas Mental Health University Institute, McGill University, 
      Montreal, Quebec, Canada.
FAU - Lepage, Martin
AU  - Lepage M
AD  - Department of Psychiatry, Prevention and Early Intervention Program for 
      Psychosis, Douglas Mental Health University Institute, McGill University, 
      Montreal, Quebec, Canada.
FAU - Collins, D Louis
AU  - Collins DL
AD  - McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill 
      University, Montreal, Quebec, Canada.
FAU - Pruessner, Jens C
AU  - Pruessner JC
AD  - Department of Psychiatry, McGill Centre for Studies in Aging, Douglas Mental 
      Health University Institute, McGill University, Montreal, Quebec, Canada.
FAU - Joober, Ridha
AU  - Joober R
AD  - Department of Psychiatry, Prevention and Early Intervention Program for 
      Psychosis, Douglas Mental Health University Institute, McGill University, 
      Montreal, Quebec, Canada.
FAU - Malla, Ashok K
AU  - Malla AK
AD  - Department of Psychiatry, Prevention and Early Intervention Program for 
      Psychosis, Douglas Mental Health University Institute, McGill University, 
      Montreal, Quebec, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141205
PL  - Netherlands
TA  - Neuroimage Clin
JT  - NeuroImage. Clinical
JID - 101597070
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adult
MH  - Female
MH  - Hippocampus/*pathology
MH  - Humans
MH  - Hydrocortisone/analysis
MH  - Hypothalamo-Hypophyseal System/*physiopathology
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Pituitary-Adrenal System/*physiopathology
MH  - Psychotic Disorders/*pathology/*physiopathology
MH  - Saliva/chemistry
MH  - *Sex Characteristics
MH  - Young Adult
PMC - PMC4300007
OTO - NOTNLM
OT  - Cortisol awakening response
OT  - First episode psychosis
OT  - Hippocampus
OT  - Hypothalamus-pituitary-adrenal axis
OT  - Sex differences
EDAT- 2015/01/23 06:00
MHDA- 2015/09/25 06:00
PMCR- 2014/12/05
CRDT- 2015/01/23 06:00
PHST- 2014/07/01 00:00 [received]
PHST- 2014/10/31 00:00 [revised]
PHST- 2014/12/01 00:00 [accepted]
PHST- 2015/01/23 06:00 [entrez]
PHST- 2015/01/23 06:00 [pubmed]
PHST- 2015/09/25 06:00 [medline]
PHST- 2014/12/05 00:00 [pmc-release]
AID - S2213-1582(14)00183-1 [pii]
AID - 10.1016/j.nicl.2014.12.001 [doi]
PST - epublish
SO  - Neuroimage Clin. 2014 Dec 5;7:195-202. doi: 10.1016/j.nicl.2014.12.001. 
      eCollection 2015.