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Research Paper
Open Access

Identifying common and distinct subcortical volumetric abnormalities in 3 major psychiatric disorders: a single-site analysis of 640 participants

Pei-Chi Tu, Wan-Chen Chang, Mu-Hong Chen, Ju-Wei Hsu, Wei-Chen Lin, Cheng-Ta Li, Tung-Ping Su and Ya-Mei Bai
J Psychiatry Neurosci June 22, 2022 47 (3) E230-E238; DOI: https://doi.org/10.1503/jpn.210154
Pei-Chi Tu
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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Wan-Chen Chang
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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Mu-Hong Chen
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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Ju-Wei Hsu
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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Wei-Chen Lin
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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Cheng-Ta Li
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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Tung-Ping Su
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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Ya-Mei Bai
From the Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang); the Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan (Tu, Chang, Chen, Hsu, Lin, Li, Bai); the Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu); the Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Tu, Chen, Hsu, Lin, Li, Su, Bai); the Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan (Chang); the Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan (Lin, Li, Su, Bai); the Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (Su)
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    Figure 1

    Subcortical structures evaluated in this study. (A) An example of the subcortical segmentations examined using FreeSurfer 7.0 in a healthy control participant. (B) The hippocampus and lateral ventricles were delineated in a 3-dimensional view for better visualization of their whole structures.

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    Figure 2

    Common and distinct subcortical volumetric abnormalities in patients with schizophrenia, bipolar disorder and MDD. (A) We assessed the model-adjusted volumes of the subcortical structures (mean ± standard deviation) for each diagnostic group and evaluated differences among the 4 diagnostic groups using general linear models; *p < 0.05 (Bonferroni-corrected) in post hoc comparisons. (B) We calculated the effect size (Cohen d) and 95% confidence interval for differences in subcortical volume between each patient group and healthy controls to better visualize common volumetric abnormalities. Decreased thalamic volume was a common feature of the 3 disorders; *p < 0.05 (Bonferroni-corrected) compared to healthy controls. MDD = major depressive disorder.

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    Table 1

    Participant demographic and clinical characteristics

    CharacteristicSchizophrenia*
    n = 160
    Bipolar disorder*
    n = 160
    MDD*
    n = 160
    Healthy controls*
    n = 160
    p value
    Sex, M/F80/8080/8047/11380/80< 0.001
    Age, yr37.0 ± 8.837.8 ± 11.536.8 ± 11.936.6 ± 8.00.72
    Education, yr13.4 ± 2.814.0 ± 2.813.7 ± 3.115.4 ± 1.8< 0.001
    Age at illness onset, yr23.7 ± 6.825.3 ± 9.930.3 ± 12.0–< 0.001
    Illness duration, yr13.2 ± 9.112.6 ± 8.96.7 ± 6.8–< 0.001
    Positive and Negative Syndrome Scale
     Total score63.6 ± 17.6––––
     Positive subscale14.4 ± 5.0––––
     Negative subscale16.9 ± 5.5––––
     Psychopathology32.3 ± 9.2––––
    Montgomery–Åsberg Depression Scale
     Mean score–13.3 ± 8.924.0 ± 9.9––
     Participants with data, n (%)–97 (60.6 )139 (86.9 )––
    Young Mania Rating Scale
     Mean score–4.3 ± 5.51.5 ± 1.9––
     Participants with data, n (%)–127 (79.4)160 (100)––
    Psychotropic use, n (%)
     Antipsychotic148 (92.5)85 (53.1)27 (16.9)––
     Antidepressant51 (31.9)38 (23.8)73 (45.6)––
     Antiepileptic77 (48.1)102 (63.8)22 (13.8)––
     Lithium6 (3.8)28 (17.5)1 (0.6)––
    • F = female; M = male; MDD = major depressive disorder; SD = standard deviation.

    • ↵* Values are mean + SD unless otherwise specified.

    • View popup
    Table 2

    Subcortical volume and group differences, general linear models

    StructureSubcortical volume, mm3*F3,363p valuePost hoc comparisons
    Schizophrenia
    n = 160
    Bipolar disorder
    n = 160
    MDD
    n = 160
    Healthy controls
    n = 160
    Thalamus7140.1 ± 760.77181.8 ± 867.07231.5 ± 808.47550.9 ± 750.16.0< 0.001†Schizophrenia = bipolar disorder = MDD < healthy controls
    Hippocampus3881.9 ± 348.74017.4 ± 405.84054.1 ± 372.94183.9 ± 386.816.5< 0.001†Schizophrenia < bipolar disorder < healthy controls; schizophrenia < MDD = healthy controls
    Amygdala1724.4 ± 207.71742.0 ± 221.01755.3 ± 213.91811.0 ± 221.33.60.014–
    Accumbens540.2 ± 103.4560.6 ± 102.0574.2 ± 101.9593.8 ± 107.55.30.001†Schizophrenia < MDD = healthy controls
    Putamen5186.6 ± 555.05076.7 ± 655.85068.3 ± 563.85279.1 ± 615.63.10.027–
    Caudate3722.9 ± 463.43599.6 ± 471.53695.9 ± 424.13763.0 ± 477.13.30.02–
    Pallidum1893.5 ± 238.91802.5 ± 241.41789.6 ± 215.81872.0 ± 222.510.9< 0.001†Schizophrenia > bipolar disorder = MDD = healthy controls
    Lateral ventricle9387.7 ± 4844.29085.3 ± 4582.97635.5 ± 3992.47365.3 ± 3514.114.6< 0.001†Schizophrenia = bipolar disorder > MDD = healthy controls
    Intracranial volume1 404 012.9 ± 183 873.21 419 487.3 ± 184 604.61 420 293.2 ± 152 378.91 460 416.2 ± 183 226.0–
    • MDD = major depressive disorder; SD = standard deviation.

    • ↵* Values are mean + SD.

    • ↵† p < 0.05 (Bonferroni corrected).

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Journal of Psychiatry and Neuroscience: 47 (3)
J Psychiatry Neurosci
Vol. 47, Issue 3
22 Jun 2022
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Identifying common and distinct subcortical volumetric abnormalities in 3 major psychiatric disorders: a single-site analysis of 640 participants
Pei-Chi Tu, Wan-Chen Chang, Mu-Hong Chen, Ju-Wei Hsu, Wei-Chen Lin, Cheng-Ta Li, Tung-Ping Su, Ya-Mei Bai
J Psychiatry Neurosci Jun 2022, 47 (3) E230-E238; DOI: 10.1503/jpn.210154

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Identifying common and distinct subcortical volumetric abnormalities in 3 major psychiatric disorders: a single-site analysis of 640 participants
Pei-Chi Tu, Wan-Chen Chang, Mu-Hong Chen, Ju-Wei Hsu, Wei-Chen Lin, Cheng-Ta Li, Tung-Ping Su, Ya-Mei Bai
J Psychiatry Neurosci Jun 2022, 47 (3) E230-E238; DOI: 10.1503/jpn.210154
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