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A comparison of regional brain volumes and white matter connectivity in subjects with stimulant induced psychosis versus schizophrenia

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Abstract

Rationale

Schizophrenia and stimulant-induced psychosis (SIP) represent two different forms of psychotic disorder, with different etiologies. While many of the symptoms of psychosis are common to both disorders, there have been few direct comparisons between these conditions, especially when controlling for stimulant use in individuals with schizophrenia.

Objectives

We directly compared both psychotic disorders with a comprehensive battery of clinical, neurocognitive and neuroanatomical measures. This included one group with SIP (and concurrent stimulant dependence) and two groups with schizophrenia (either with or without concurrent stimulant dependence).

Methods

Ninety-six participants were recruited from a marginalized urban population, which included 39 with SIP (and concurrent stimulant dependence), 18 with schizophrenia (without stimulant dependence), and 39 with schizophrenia (with concurrent stimulant dependence). All subjects had extensive clinical and neurocognitive evaluations, complemented with structural MRI including diffusion tensor imaging (DTI) sequences to determine regional brain volumes and white matter connectivity.

Results

Both positive and negative symptoms were greater in the SZ-dependent group than the other two. Neurocognitive function was broadly similar. The structural brain imaging revealed lateralized changes to the left parietal/temporal lobe, in which regional volumes were smaller in the SZ-dependent than the SZ-non-dependent group. DTI analysis indicated extensive decreases in fractional anisotropy, with parallel increases in radial diffusivity, in the SIP group compared to the SZ-dependent group.

Conclusions

These findings reveal both similarities and differences between SIP and schizophrenia. Furthermore, schizophrenia with concurrent stimulant dependence may be associated with a different clinical and neuroanatomical profile as compared to schizophrenia alone.

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Acknowledgments

The study was funded by the Canadian Institutes for Health Research (CBG-101827, MOP-137103) and the British Columbia Mental Health and Substance Use Services (an Agency of the Provincial Health Services Authority).

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  1. Peter D. Alexander and Kristina M. Gicas contributed equally to this work.

Authors and Affiliations

  1. Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, 2176 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada

    Peter D. Alexander & Alasdair M. Barr

  2. Department of Psychiatry, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada

    Kristina M. Gicas, Alex Cheng, Ric M. Procyshyn, William J. Panenka, Jamie Y. X. Wong, Tasha Chan, Andrea A. Jones, F. Vila-Rodriguez & William G. Honer

  3. Department of Radiology, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada

    Donna J. Lang, Alexandra T. Vertinsky & Alexander Rauscher

  4. Department of Psychology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada

    Allen E. Thornton

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  1. Peter D. Alexander
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Correspondence to Alasdair M. Barr.

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Conflict of interest

Drs. Gicas, Lang, Panenka, Rauscher, Vila-Rodriguez, and Barr report no competing interests. Mr. Alexander and Ms. Wong, Chan and Jones report no competing interests.

Dr. Honer has received consulting fees or sat on paid advisory boards for In Silico, Otsuka/Lundbeck, Roche, and Eli Lilly received honoraria from Rush University, University of Ottawa, University of Calgary, University of Hong Kong, British Columbia Health Authorities, the British Association for Psychopharmacology, and the Canadian Psychiatric Association, and received grants from the Canadian Institutes of Health Research (CIHR).

Dr. Procyshyn has received consulting fees from Janssen, Lundbeck, Otsuka, Pfizer, and Sunovion and is on the speaker’s bureau for AstraZeneca, Janssen, Lundbeck, Otsuka, and Pfizer, and received grants from the Canadian Institutes of Health Research.

Dr. Thornton has received grants from the William and Ada Isabelle Steel Fund and the Canadian Institutes of Health Research.

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Alexander, P.D., Gicas, K.M., Cheng, A. et al. A comparison of regional brain volumes and white matter connectivity in subjects with stimulant induced psychosis versus schizophrenia. Psychopharmacology 236, 3385–3399 (2019). https://doi.org/10.1007/s00213-019-05298-w

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