W.O. Faustman

Cortical gray matter deficit in patients with bipolar disorder

BACKGROUND cortical gray matter volume deficit and ventricular enlargement are well documented in schizophrenia, but their presence in bipolar disorder is less well established. METHODS global cortical gray matter, white matter and sulcal CSF, as well as lateral and third ventricular volume measures, were derived from axial MRI brain images obtained on age-matched bipolar (n=9), schizophrenic (n=9), and control (n=16) subjects. All subjects were free of history of alcohol or other substance dependence. RESULTS relative to controls, bipolar patients had widespread volume deficits of cortical gray matter but not of cortical white matter. Schizophrenic patients had an even more severe cortical gray matter deficit and greater sulcal and lateral ventricular enlargement than the bipolar patients. CONCLUSIONS this group of patients with bipolar disorder had a widespread deficit of cortical gray matter similar to, but less pronounced than, that observed in patients with schizophrenia.

Limitations of the Mini-Mental State Examination in predicting neuropsychological functioning in a psychiatric sample

The present study examined the ability of the Mini‐Mental State Examination (MMSE), a cognitive screening test commonly employed in research and clinical applications, to predict level of performance on a comprehensive neuropsychological battery, the Luria‐Nebraska Neuropsychological Battery (LNNB). The tests were administered to a diagnostically mixed sample of 90 psychiatric inpatients. Correlations between the tests were statistically significant but modest and the MMSE was not able to detect many patients who demonstrated significant deficits on the LNNB. Additional correlational analyses between the MMSE and the Wechsler Adult Intelligence Scale‐Revised in a subset of patients (n= 72) also showed a modest relationship between these instruments. The results suggest that the MMSE may seriously underestimate cognitive impairment in samples exclusively composed of psychiatric patients, making it inappropriate to rely solely on this instrument to distinguish psychiatric patients with and without cognitive deficit.

Brain volume abnormalities in schizophrenia are not related to age of onset

these limitations by utilizing an innovative new technique of morphomettic analysis that allows the identification of averaged anatomy via simultaneous quantification of multiple landmarks. Thirty patients with schizopluenia, with variable levels of chmnicity will be compared with 30 normal controls matched on age, sex, and socioeconomic status. Both patients and controls will undergo standardized, comprehensive neuropsychological and psychosocial testing batteries to document current functioning, estimates of premorbid intellectual ability and level of cognitive deterioration, premorbid psychosocial functioning and level of psychosocial deterioration. MRI scans obtained in the midsagittal plane will be morphometrically analyzed using the new technique, and averaged anatomy quantified. Regional or global differences between patients and controis will be determined and quantified. The identified abnormalities will be examined to determine clinical, neuropsychological, and developmental correlates. By so doing, the present study will further elucidate perplexing questions regarding possible anatomic sites underlying the pathophysiology of the schizophrenia syndrome, and to generate hypotheses for future investigations. MH30854 and DVA]