Association of hospitalization with structural brain alterations in patients with affective disorders over nine years
Abstract Repeated hospitalizations are a characteristic of severe disease courses in patients with affective disorders (PAD). To elucidate how a hospitalization during a nine-year follow-up in PAD affects brain structure, a longitudinal case-control study (mean [SD] follow-up period 8.98 [2.20] year...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2023-05-01
|
| Series: | Translational Psychiatry |
| Online Access: | https://doi.org/10.1038/s41398-023-02452-z |
| _version_ | 1797822656343441408 |
|---|---|
| author | Katharina Förster Dominik Grotegerd Katharina Dohm Hannah Lemke Verena Enneking Susanne Meinert Ronny Redlich Walter Heindel Jochen Bauer Harald Kugel Thomas Suslow Patricia Ohrmann Angela Carballedo Veronica O’Keane Andrew Fagan Kelly Doolin Hazel McCarthy Philipp Kanske Thomas Frodl Udo Dannlowski |
| author_facet | Katharina Förster Dominik Grotegerd Katharina Dohm Hannah Lemke Verena Enneking Susanne Meinert Ronny Redlich Walter Heindel Jochen Bauer Harald Kugel Thomas Suslow Patricia Ohrmann Angela Carballedo Veronica O’Keane Andrew Fagan Kelly Doolin Hazel McCarthy Philipp Kanske Thomas Frodl Udo Dannlowski |
| author_sort | Katharina Förster |
| collection | DOAJ |
| description | Abstract Repeated hospitalizations are a characteristic of severe disease courses in patients with affective disorders (PAD). To elucidate how a hospitalization during a nine-year follow-up in PAD affects brain structure, a longitudinal case-control study (mean [SD] follow-up period 8.98 [2.20] years) was conducted using structural neuroimaging. We investigated PAD (N = 38) and healthy controls (N = 37) at two sites (University of Münster, Germany, Trinity College Dublin, Ireland). PAD were divided into two groups based on the experience of in-patient psychiatric treatment during follow-up. Since the Dublin-patients were outpatients at baseline, the re-hospitalization analysis was limited to the Münster site (N = 52). Voxel-based morphometry was employed to examine hippocampus, insula, dorsolateral prefrontal cortex and whole-brain gray matter in two models: (1) group (patients/controls)×time (baseline/follow-up) interaction; (2) group (hospitalized patients/not-hospitalized patients/controls)×time interaction. Patients lost significantly more whole-brain gray matter volume of superior temporal gyrus and temporal pole compared to HC (p FWE = 0.008). Patients hospitalized during follow-up lost significantly more insular volume than healthy controls (p FWE = 0.025) and more volume in their hippocampus compared to not-hospitalized patients (p FWE = 0.023), while patients without re-hospitalization did not differ from controls. These effects of hospitalization remained stable in a smaller sample excluding patients with bipolar disorder. PAD show gray matter volume decline in temporo-limbic regions over nine years. A hospitalization during follow-up comes with intensified gray matter volume decline in the insula and hippocampus. Since hospitalizations are a correlate of severity, this finding corroborates and extends the hypothesis that a severe course of disease has detrimental long-term effects on temporo-limbic brain structure in PAD. |
| first_indexed | 2024-03-13T10:11:17Z |
| format | Article |
| id | doaj.art-266fca6d98e64099b0c783a8455b3b5f |
| institution | Directory Open Access Journal |
| issn | 2158-3188 |
| language | English |
| last_indexed | 2024-03-13T10:11:17Z |
| publishDate | 2023-05-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Translational Psychiatry |
| spelling | doaj.art-266fca6d98e64099b0c783a8455b3b5f2023-05-21T11:28:05ZengNature Publishing GroupTranslational Psychiatry2158-31882023-05-011311710.1038/s41398-023-02452-zAssociation of hospitalization with structural brain alterations in patients with affective disorders over nine yearsKatharina Förster0Dominik Grotegerd1Katharina Dohm2Hannah Lemke3Verena Enneking4Susanne Meinert5Ronny Redlich6Walter Heindel7Jochen Bauer8Harald Kugel9Thomas Suslow10Patricia Ohrmann11Angela Carballedo12Veronica O’Keane13Andrew Fagan14Kelly Doolin15Hazel McCarthy16Philipp Kanske17Thomas Frodl18Udo Dannlowski19Institute for Translational Psychiatry, University of MünsterInstitute for Translational Psychiatry, University of MünsterInstitute for Translational Psychiatry, University of MünsterInstitute for Translational Psychiatry, University of MünsterInstitute for Translational Psychiatry, University of MünsterInstitute for Translational Psychiatry, University of MünsterInstitute for Translational Psychiatry, University of MünsterDepartment of Radiology, University of Münster and University Hospital MünsterDepartment of Radiology, University of Münster and University Hospital MünsterDepartment of Radiology, University of Münster and University Hospital MünsterDepartment of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical CenterLWL-Hospital MuensterDepartment of Psychiatry & Trinity College Institute of Neuroscience, University DublinDepartment of Psychiatry & Trinity College Institute of Neuroscience, University DublinDepartment of Radiology, Mayo ClinicDepartment of Psychiatry & Trinity College Institute of Neuroscience, University DublinDepartment of Psychiatry & Trinity College Institute of Neuroscience, University DublinClinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität DresdenDepartment of Psychiatry & Trinity College Institute of Neuroscience, University DublinInstitute for Translational Psychiatry, University of MünsterAbstract Repeated hospitalizations are a characteristic of severe disease courses in patients with affective disorders (PAD). To elucidate how a hospitalization during a nine-year follow-up in PAD affects brain structure, a longitudinal case-control study (mean [SD] follow-up period 8.98 [2.20] years) was conducted using structural neuroimaging. We investigated PAD (N = 38) and healthy controls (N = 37) at two sites (University of Münster, Germany, Trinity College Dublin, Ireland). PAD were divided into two groups based on the experience of in-patient psychiatric treatment during follow-up. Since the Dublin-patients were outpatients at baseline, the re-hospitalization analysis was limited to the Münster site (N = 52). Voxel-based morphometry was employed to examine hippocampus, insula, dorsolateral prefrontal cortex and whole-brain gray matter in two models: (1) group (patients/controls)×time (baseline/follow-up) interaction; (2) group (hospitalized patients/not-hospitalized patients/controls)×time interaction. Patients lost significantly more whole-brain gray matter volume of superior temporal gyrus and temporal pole compared to HC (p FWE = 0.008). Patients hospitalized during follow-up lost significantly more insular volume than healthy controls (p FWE = 0.025) and more volume in their hippocampus compared to not-hospitalized patients (p FWE = 0.023), while patients without re-hospitalization did not differ from controls. These effects of hospitalization remained stable in a smaller sample excluding patients with bipolar disorder. PAD show gray matter volume decline in temporo-limbic regions over nine years. A hospitalization during follow-up comes with intensified gray matter volume decline in the insula and hippocampus. Since hospitalizations are a correlate of severity, this finding corroborates and extends the hypothesis that a severe course of disease has detrimental long-term effects on temporo-limbic brain structure in PAD.https://doi.org/10.1038/s41398-023-02452-z |
| spellingShingle | Katharina Förster Dominik Grotegerd Katharina Dohm Hannah Lemke Verena Enneking Susanne Meinert Ronny Redlich Walter Heindel Jochen Bauer Harald Kugel Thomas Suslow Patricia Ohrmann Angela Carballedo Veronica O’Keane Andrew Fagan Kelly Doolin Hazel McCarthy Philipp Kanske Thomas Frodl Udo Dannlowski Association of hospitalization with structural brain alterations in patients with affective disorders over nine years Translational Psychiatry |
| title | Association of hospitalization with structural brain alterations in patients with affective disorders over nine years |
| title_full | Association of hospitalization with structural brain alterations in patients with affective disorders over nine years |
| title_fullStr | Association of hospitalization with structural brain alterations in patients with affective disorders over nine years |
| title_full_unstemmed | Association of hospitalization with structural brain alterations in patients with affective disorders over nine years |
| title_short | Association of hospitalization with structural brain alterations in patients with affective disorders over nine years |
| title_sort | association of hospitalization with structural brain alterations in patients with affective disorders over nine years |
| url | https://doi.org/10.1038/s41398-023-02452-z |
| work_keys_str_mv | AT katharinaforster associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT dominikgrotegerd associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT katharinadohm associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT hannahlemke associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT verenaenneking associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT susannemeinert associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT ronnyredlich associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT walterheindel associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT jochenbauer associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT haraldkugel associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT thomassuslow associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT patriciaohrmann associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT angelacarballedo associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT veronicaokeane associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT andrewfagan associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT kellydoolin associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT hazelmccarthy associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT philippkanske associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT thomasfrodl associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears AT udodannlowski associationofhospitalizationwithstructuralbrainalterationsinpatientswithaffectivedisordersovernineyears |