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Robert W. Mccarley - One of the best experts on this subject based on the ideXlab platform.

  • Cavum septi pellucidi in first-episode schizophrenia and first-episode affective Psychosis: an MRI study
    Schizophrenia research, 2004
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Robert W. Mccarley, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Susan Demeo, Martha E. Shenton
    Abstract:

    A high prevalence of abnormal cavum septi pellucidi (CSP) in schizophrenia may reflect neurodevelopmental abnormalities in midline structures of the brain. The relationship, however, between abnormal CSP and clinical symptoms, and with abnormalities in other limbic structures remains unclear, as does the question of whether a similar abnormality is present in affective Psychosis. Seventy-four patients at their first hospitalization, 33 with schizophrenia and 41 with affective (mainly Manic) Psychosis, and 56 healthy control subjects underwent high-spatial-resolution magnetic resonance imaging (MRI). CSP on six slices or more on 0.9375-mm resampled coronal images was categorized as abnormal. The prevalence of abnormal CSP in both schizophrenic patients (26.1%) and affective Psychosis patients (18.2%) was significantly higher than was observed in control subjects (8.2%). In schizophrenic patients only, larger CSP was significantly associated with more severe thinking disturbance and smaller left parahippocampal gyrus gray matter volumes. While the relationships between CSP ratings and clinical symptoms did not significantly differ between the two Psychosis groups as assessed by the comparison of regression slopes, the association with limbic volumes appeared to be specific to schizophrenic patients. These results suggest that Psychosis associated with schizophrenia and affective disorder share, at least to some extent, neurodevelopmental abnormalities involving midline structures and associated psychopathological consequences. However, the association between abnormal CSP and limbic systems may be more specific to schizophrenia.

  • progressive decrease of left heschl gyrus and planum temporale gray matter volume in first episode schizophrenia a longitudinal magnetic resonance imaging study
    Archives of General Psychiatry, 2003
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Martha E. Shenton, Yoshio Hirayasu, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Magdalena H Spencer, Deborah A Yurgeluntodd, Robert W. Mccarley
    Abstract:

    Background: The Heschl gyrus and planum temporale have crucial roles in auditory perception and language processing. Our previous investigation using magnetic resonance imaging (MRI) indicated smaller gray matter volumes bilaterally in the Heschl gyrus and in left planum temporale in patients with firstepisode schizophrenia but not in patients with firstepisode affective Psychosis. We sought to determine whether there are progressive decreases in anatomically defined MRI gray matter volumes of the Heschl gyrus and planum temporale in patients with firstepisode schizophrenia and also in patients with firstepisode affective Psychosis. Methods: At a private psychiatric hospital, we conducted a prospective high spatial resolution MRI study that included initial scans of 28 patients at their first hospitalization (13 with schizophrenia and 15 with affective Psychosis, 13 of whom had a Manic Psychosis) and 22 healthy control subjects. Follow-up scans occurred, on average, 1.5 years after the initial scan. Results: Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left Heschl gyrus (6.9%) and left planum temporale (7.2%) compared with patients with first-episode affective Psychosis or control subjects. Conclusions: These findings demonstrate a left-biased progressive volume reduction in the Heschl gyrus and planum temporale gray matter in patients with first-episode schizophrenia in contrast to patients with first-episode affective Psychosis and control subjects. Schizophrenia but not affective Psychosis seems to be characterized by a postonset progression of neocortical gray matter volume loss in the left superior temporal gyrus and thus may not be developmentally fixed. Arch Gen Psychiatry. 2003;60:766-775

  • Planum Temporale and Heschl Gyrus Volume Reduction in Schizophrenia A Magnetic Resonance Imaging Study of First-Episode Patients
    Archives of general psychiatry, 2000
    Co-Authors: Yoshio Hirayasu, Dean F. Salisbury, Robert W. Mccarley, Shin Tanaka, Jun Soo Kwon, Melissa Frumin, Danielle Snyderman, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz
    Abstract:

    Background: Magnetic resonance imaging studies in schizophrenia have revealed abnormalities in temporal lobe structures, including the superior temporal gyrus. More specifically, abnormalities have been reported in the posterior superior temporal gyrus, which includes the Heschl gyrus and planum temporale, the latter being an important substrate for language. However, the specificity of the Heschl gyrus and planum temporale structural abnormalities to schizophrenia vs affective Psychosis, and the possible confounding roles of chronic morbidity and neuroleptic treatment, remain unclear. Methods: Magnetic resonance images were acquired using a 1.5-T magnet from 20 first-episode (at first hospitalization) patients with schizophrenia (mean age, 27.3 years), 24 first-episode patients with Manic Psychosis (mean age, 23.6 years), and 22 controls (mean age, 24.5 years). There was no significant difference in age for the 3 groups. All brain images were uniformly aligned and then reformatted and resampled to yield isotropic voxels. Results: Gray matter volume of the left planum temporale differed among the 3 groups. The patients with schizophrenia had significantly smaller left planum temporale volume than controls (20.0%) and patients with mania (20.0%). Heschl gyrus gray matter volume (left and right) was also reduced in patients with schizophrenia compared with controls (13.1%) and patients with bipolar mania (16.8%). Conclusions: Compared with controls and patients with bipolar Manic Psychosis, patients with first-episode schizophrenia showed left planum temporale gray matter volume reduction and bilateral Heschl gyrus gray matter volume reduction. These findings are similar to those reported in patients with chronic schizophrenia and suggest that such abnormalities are present at first episode and are specific to schizophrenia.

  • P300 topography differs in schizophrenia and Manic Psychosis
    Biological psychiatry, 1999
    Co-Authors: Dean F. Salisbury, Martha E. Shenton, Robert W. Mccarley
    Abstract:

    Abstract Background: Overall and left temporal scalp area reductions of P300 have been demonstrated in schizophrenia. P300 amplitude and topography in psychotic affective disorder, a crucial comparison in assessing the specificity of P300 abnormalities to schizophrenia, are not well studied. Methods: P300 was recorded from 35 schizophrenic, 20 psychotic Manic, and 30 control subjects. All were right-handed men. Results: P300 was reduced in both psychotic groups relative to control subjects. Anteroposterior P300 topography differed between patient groups, with schizophrenic subjects showing posterior reduction and bipolar subjects showing anterior reduction. Schizophrenic subjects showed an abnormal asymmetry, with smaller P300 over the left temporal scalp site than the right. Both bipolar and control subjects showed a left greater than right asymmetry. Conclusions: Widespread auditory P300 reductions were present in schizophrenia and bipolar disorder with Psychosis, but subtle topographic differences were present in the two diseases. Although unequivocal knowledge of neural generators cannot be derived from topography alone, differences in topography imply different generator configurations. Based on previous studies, the posterior P300 reductions in schizophrenia may reflect abnormalities of a generator located in the left superior temporal gyrus. The frontal reductions in bipolar Psychosis may reflect abnormalities in a hypothetical frontal generator, consonant with reports of altered frontal lobe function in mania.

Ferenc A. Jolesz - One of the best experts on this subject based on the ideXlab platform.

  • Cavum septi pellucidi in first-episode schizophrenia and first-episode affective Psychosis: an MRI study
    Schizophrenia research, 2004
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Robert W. Mccarley, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Susan Demeo, Martha E. Shenton
    Abstract:

    A high prevalence of abnormal cavum septi pellucidi (CSP) in schizophrenia may reflect neurodevelopmental abnormalities in midline structures of the brain. The relationship, however, between abnormal CSP and clinical symptoms, and with abnormalities in other limbic structures remains unclear, as does the question of whether a similar abnormality is present in affective Psychosis. Seventy-four patients at their first hospitalization, 33 with schizophrenia and 41 with affective (mainly Manic) Psychosis, and 56 healthy control subjects underwent high-spatial-resolution magnetic resonance imaging (MRI). CSP on six slices or more on 0.9375-mm resampled coronal images was categorized as abnormal. The prevalence of abnormal CSP in both schizophrenic patients (26.1%) and affective Psychosis patients (18.2%) was significantly higher than was observed in control subjects (8.2%). In schizophrenic patients only, larger CSP was significantly associated with more severe thinking disturbance and smaller left parahippocampal gyrus gray matter volumes. While the relationships between CSP ratings and clinical symptoms did not significantly differ between the two Psychosis groups as assessed by the comparison of regression slopes, the association with limbic volumes appeared to be specific to schizophrenic patients. These results suggest that Psychosis associated with schizophrenia and affective disorder share, at least to some extent, neurodevelopmental abnormalities involving midline structures and associated psychopathological consequences. However, the association between abnormal CSP and limbic systems may be more specific to schizophrenia.

  • progressive decrease of left heschl gyrus and planum temporale gray matter volume in first episode schizophrenia a longitudinal magnetic resonance imaging study
    Archives of General Psychiatry, 2003
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Martha E. Shenton, Yoshio Hirayasu, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Magdalena H Spencer, Deborah A Yurgeluntodd, Robert W. Mccarley
    Abstract:

    Background: The Heschl gyrus and planum temporale have crucial roles in auditory perception and language processing. Our previous investigation using magnetic resonance imaging (MRI) indicated smaller gray matter volumes bilaterally in the Heschl gyrus and in left planum temporale in patients with firstepisode schizophrenia but not in patients with firstepisode affective Psychosis. We sought to determine whether there are progressive decreases in anatomically defined MRI gray matter volumes of the Heschl gyrus and planum temporale in patients with firstepisode schizophrenia and also in patients with firstepisode affective Psychosis. Methods: At a private psychiatric hospital, we conducted a prospective high spatial resolution MRI study that included initial scans of 28 patients at their first hospitalization (13 with schizophrenia and 15 with affective Psychosis, 13 of whom had a Manic Psychosis) and 22 healthy control subjects. Follow-up scans occurred, on average, 1.5 years after the initial scan. Results: Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left Heschl gyrus (6.9%) and left planum temporale (7.2%) compared with patients with first-episode affective Psychosis or control subjects. Conclusions: These findings demonstrate a left-biased progressive volume reduction in the Heschl gyrus and planum temporale gray matter in patients with first-episode schizophrenia in contrast to patients with first-episode affective Psychosis and control subjects. Schizophrenia but not affective Psychosis seems to be characterized by a postonset progression of neocortical gray matter volume loss in the left superior temporal gyrus and thus may not be developmentally fixed. Arch Gen Psychiatry. 2003;60:766-775

  • Prefrontal Gray Matter Volume Reduction in First Episode Schizophrenia
    Cerebral cortex (New York N.Y. : 1991), 2001
    Co-Authors: Yoshio Hirayasu, Dean F. Salisbury, Martha E. Shenton, Shin Tanaka, Deborah A. Yurgelun-todd, Ron Kikinis, Massimo A. Desantis, James J. Levitt, Cynthia G. Wible, Ferenc A. Jolesz
    Abstract:

    Functional measures have consistently shown prefrontal abnormalities in schizophrenia. However, structural magnetic resonance imaging (MRI) findings of prefrontal volume reduction have been less consistent. In this study, we evaluated prefrontal gray matter volume in first episode (first hospitalized) patients diagnosed with schizophrenia, compared with first episode patients diagnosed with affective Psychosis and normal comparison subjects, to determine the presence in and specificity of prefrontal abnormalities to schizophrenia. Prefrontal gray and white matter volumes were measured from first episode patients with schizophrenia (n = 17), and from gender and parental socio-economic status-matched subjects with affective (mainly Manic) Psychosis (n = 17) and normal comparison subjects (n = 17), age-matched within a narrow age range (18--29 years). Total (left and right) prefrontal gray matter volume was significantly reduced in first episode schizophrenia compared with first episode affective Psychosis and comparison subjects. Follow-up analyses indicated significant left prefrontal gray matter volume reduction and trend level reduction on the right. Schizophrenia patients showed 9.2% reduction on the left and 7.7% reduction on the right compared with comparison subjects. White matter volumes did not differ among groups. These data suggest that prefrontal cortical gray matter volume reduction is selectively present at first hospitalization in schizophrenia but not affective Psychosis.

  • Planum Temporale and Heschl Gyrus Volume Reduction in Schizophrenia A Magnetic Resonance Imaging Study of First-Episode Patients
    Archives of general psychiatry, 2000
    Co-Authors: Yoshio Hirayasu, Dean F. Salisbury, Robert W. Mccarley, Shin Tanaka, Jun Soo Kwon, Melissa Frumin, Danielle Snyderman, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz
    Abstract:

    Background: Magnetic resonance imaging studies in schizophrenia have revealed abnormalities in temporal lobe structures, including the superior temporal gyrus. More specifically, abnormalities have been reported in the posterior superior temporal gyrus, which includes the Heschl gyrus and planum temporale, the latter being an important substrate for language. However, the specificity of the Heschl gyrus and planum temporale structural abnormalities to schizophrenia vs affective Psychosis, and the possible confounding roles of chronic morbidity and neuroleptic treatment, remain unclear. Methods: Magnetic resonance images were acquired using a 1.5-T magnet from 20 first-episode (at first hospitalization) patients with schizophrenia (mean age, 27.3 years), 24 first-episode patients with Manic Psychosis (mean age, 23.6 years), and 22 controls (mean age, 24.5 years). There was no significant difference in age for the 3 groups. All brain images were uniformly aligned and then reformatted and resampled to yield isotropic voxels. Results: Gray matter volume of the left planum temporale differed among the 3 groups. The patients with schizophrenia had significantly smaller left planum temporale volume than controls (20.0%) and patients with mania (20.0%). Heschl gyrus gray matter volume (left and right) was also reduced in patients with schizophrenia compared with controls (13.1%) and patients with bipolar mania (16.8%). Conclusions: Compared with controls and patients with bipolar Manic Psychosis, patients with first-episode schizophrenia showed left planum temporale gray matter volume reduction and bilateral Heschl gyrus gray matter volume reduction. These findings are similar to those reported in patients with chronic schizophrenia and suggest that such abnormalities are present at first episode and are specific to schizophrenia.

Dean F. Salisbury - One of the best experts on this subject based on the ideXlab platform.

  • Cavum septi pellucidi in first-episode schizophrenia and first-episode affective Psychosis: an MRI study
    Schizophrenia research, 2004
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Robert W. Mccarley, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Susan Demeo, Martha E. Shenton
    Abstract:

    A high prevalence of abnormal cavum septi pellucidi (CSP) in schizophrenia may reflect neurodevelopmental abnormalities in midline structures of the brain. The relationship, however, between abnormal CSP and clinical symptoms, and with abnormalities in other limbic structures remains unclear, as does the question of whether a similar abnormality is present in affective Psychosis. Seventy-four patients at their first hospitalization, 33 with schizophrenia and 41 with affective (mainly Manic) Psychosis, and 56 healthy control subjects underwent high-spatial-resolution magnetic resonance imaging (MRI). CSP on six slices or more on 0.9375-mm resampled coronal images was categorized as abnormal. The prevalence of abnormal CSP in both schizophrenic patients (26.1%) and affective Psychosis patients (18.2%) was significantly higher than was observed in control subjects (8.2%). In schizophrenic patients only, larger CSP was significantly associated with more severe thinking disturbance and smaller left parahippocampal gyrus gray matter volumes. While the relationships between CSP ratings and clinical symptoms did not significantly differ between the two Psychosis groups as assessed by the comparison of regression slopes, the association with limbic volumes appeared to be specific to schizophrenic patients. These results suggest that Psychosis associated with schizophrenia and affective disorder share, at least to some extent, neurodevelopmental abnormalities involving midline structures and associated psychopathological consequences. However, the association between abnormal CSP and limbic systems may be more specific to schizophrenia.

  • progressive decrease of left heschl gyrus and planum temporale gray matter volume in first episode schizophrenia a longitudinal magnetic resonance imaging study
    Archives of General Psychiatry, 2003
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Martha E. Shenton, Yoshio Hirayasu, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Magdalena H Spencer, Deborah A Yurgeluntodd, Robert W. Mccarley
    Abstract:

    Background: The Heschl gyrus and planum temporale have crucial roles in auditory perception and language processing. Our previous investigation using magnetic resonance imaging (MRI) indicated smaller gray matter volumes bilaterally in the Heschl gyrus and in left planum temporale in patients with firstepisode schizophrenia but not in patients with firstepisode affective Psychosis. We sought to determine whether there are progressive decreases in anatomically defined MRI gray matter volumes of the Heschl gyrus and planum temporale in patients with firstepisode schizophrenia and also in patients with firstepisode affective Psychosis. Methods: At a private psychiatric hospital, we conducted a prospective high spatial resolution MRI study that included initial scans of 28 patients at their first hospitalization (13 with schizophrenia and 15 with affective Psychosis, 13 of whom had a Manic Psychosis) and 22 healthy control subjects. Follow-up scans occurred, on average, 1.5 years after the initial scan. Results: Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left Heschl gyrus (6.9%) and left planum temporale (7.2%) compared with patients with first-episode affective Psychosis or control subjects. Conclusions: These findings demonstrate a left-biased progressive volume reduction in the Heschl gyrus and planum temporale gray matter in patients with first-episode schizophrenia in contrast to patients with first-episode affective Psychosis and control subjects. Schizophrenia but not affective Psychosis seems to be characterized by a postonset progression of neocortical gray matter volume loss in the left superior temporal gyrus and thus may not be developmentally fixed. Arch Gen Psychiatry. 2003;60:766-775

  • Prefrontal Gray Matter Volume Reduction in First Episode Schizophrenia
    Cerebral cortex (New York N.Y. : 1991), 2001
    Co-Authors: Yoshio Hirayasu, Dean F. Salisbury, Martha E. Shenton, Shin Tanaka, Deborah A. Yurgelun-todd, Ron Kikinis, Massimo A. Desantis, James J. Levitt, Cynthia G. Wible, Ferenc A. Jolesz
    Abstract:

    Functional measures have consistently shown prefrontal abnormalities in schizophrenia. However, structural magnetic resonance imaging (MRI) findings of prefrontal volume reduction have been less consistent. In this study, we evaluated prefrontal gray matter volume in first episode (first hospitalized) patients diagnosed with schizophrenia, compared with first episode patients diagnosed with affective Psychosis and normal comparison subjects, to determine the presence in and specificity of prefrontal abnormalities to schizophrenia. Prefrontal gray and white matter volumes were measured from first episode patients with schizophrenia (n = 17), and from gender and parental socio-economic status-matched subjects with affective (mainly Manic) Psychosis (n = 17) and normal comparison subjects (n = 17), age-matched within a narrow age range (18--29 years). Total (left and right) prefrontal gray matter volume was significantly reduced in first episode schizophrenia compared with first episode affective Psychosis and comparison subjects. Follow-up analyses indicated significant left prefrontal gray matter volume reduction and trend level reduction on the right. Schizophrenia patients showed 9.2% reduction on the left and 7.7% reduction on the right compared with comparison subjects. White matter volumes did not differ among groups. These data suggest that prefrontal cortical gray matter volume reduction is selectively present at first hospitalization in schizophrenia but not affective Psychosis.

  • Planum Temporale and Heschl Gyrus Volume Reduction in Schizophrenia A Magnetic Resonance Imaging Study of First-Episode Patients
    Archives of general psychiatry, 2000
    Co-Authors: Yoshio Hirayasu, Dean F. Salisbury, Robert W. Mccarley, Shin Tanaka, Jun Soo Kwon, Melissa Frumin, Danielle Snyderman, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz
    Abstract:

    Background: Magnetic resonance imaging studies in schizophrenia have revealed abnormalities in temporal lobe structures, including the superior temporal gyrus. More specifically, abnormalities have been reported in the posterior superior temporal gyrus, which includes the Heschl gyrus and planum temporale, the latter being an important substrate for language. However, the specificity of the Heschl gyrus and planum temporale structural abnormalities to schizophrenia vs affective Psychosis, and the possible confounding roles of chronic morbidity and neuroleptic treatment, remain unclear. Methods: Magnetic resonance images were acquired using a 1.5-T magnet from 20 first-episode (at first hospitalization) patients with schizophrenia (mean age, 27.3 years), 24 first-episode patients with Manic Psychosis (mean age, 23.6 years), and 22 controls (mean age, 24.5 years). There was no significant difference in age for the 3 groups. All brain images were uniformly aligned and then reformatted and resampled to yield isotropic voxels. Results: Gray matter volume of the left planum temporale differed among the 3 groups. The patients with schizophrenia had significantly smaller left planum temporale volume than controls (20.0%) and patients with mania (20.0%). Heschl gyrus gray matter volume (left and right) was also reduced in patients with schizophrenia compared with controls (13.1%) and patients with bipolar mania (16.8%). Conclusions: Compared with controls and patients with bipolar Manic Psychosis, patients with first-episode schizophrenia showed left planum temporale gray matter volume reduction and bilateral Heschl gyrus gray matter volume reduction. These findings are similar to those reported in patients with chronic schizophrenia and suggest that such abnormalities are present at first episode and are specific to schizophrenia.

  • P300 topography differs in schizophrenia and Manic Psychosis
    Biological psychiatry, 1999
    Co-Authors: Dean F. Salisbury, Martha E. Shenton, Robert W. Mccarley
    Abstract:

    Abstract Background: Overall and left temporal scalp area reductions of P300 have been demonstrated in schizophrenia. P300 amplitude and topography in psychotic affective disorder, a crucial comparison in assessing the specificity of P300 abnormalities to schizophrenia, are not well studied. Methods: P300 was recorded from 35 schizophrenic, 20 psychotic Manic, and 30 control subjects. All were right-handed men. Results: P300 was reduced in both psychotic groups relative to control subjects. Anteroposterior P300 topography differed between patient groups, with schizophrenic subjects showing posterior reduction and bipolar subjects showing anterior reduction. Schizophrenic subjects showed an abnormal asymmetry, with smaller P300 over the left temporal scalp site than the right. Both bipolar and control subjects showed a left greater than right asymmetry. Conclusions: Widespread auditory P300 reductions were present in schizophrenia and bipolar disorder with Psychosis, but subtle topographic differences were present in the two diseases. Although unequivocal knowledge of neural generators cannot be derived from topography alone, differences in topography imply different generator configurations. Based on previous studies, the posterior P300 reductions in schizophrenia may reflect abnormalities of a generator located in the left superior temporal gyrus. The frontal reductions in bipolar Psychosis may reflect abnormalities in a hypothetical frontal generator, consonant with reports of altered frontal lobe function in mania.

Ian B Kerr - One of the best experts on this subject based on the ideXlab platform.

  • brief cognitive analytic therapy for post acute Manic Psychosis on a psychiatric intensive care unit
    Clinical Psychology & Psychotherapy, 2001
    Co-Authors: Ian B Kerr
    Abstract:

    A study of the efficacy of brief cognitive analytic therapy (CAT) with a series of patients (n = 4) with treatment-resistant Manic Psychosis on a psychiatric intensive care unit (PICU) was carried out. In one patient such an intervention proved redundant given an improved medication regime and subsequent willingness to comply with treatment. In a second, it proved impossible, in this context at least, due to fixed grandiose and paranoid delusions. In two others, however, this approach, particularly the technique of joint ‘reformulation’, appeared to be remarkably containing and effective with rapid subsidence of disturbed and non-compliant behaviour. Much of the ‘psychotic’ psychopathology of these patients became comprehensible within this model in terms of secondary, ‘self-state’ or narcissistic damage and enactment of maladaptive ‘procedures’ and ‘reciprocal roles’. Additionally, discussion of these procedures and the reciprocal roles elicited from and enacted by staff produced a marked change in attitude and behaviour by them. In one of these patients, improvement was such that transfer to an open ward was possible within a week and discharge soon after. Subsequent treatment was markedly more collaborative and enabling of good social function. It appears that CAT and its collaborative use of the ‘tools’ of reformulation could play an important role in the treatment of psychotic disorders in this and possibly other settings. Copyright © 2001 John Wiley & Sons, Ltd.

  • Brief cognitive analytic therapy for post‐acute Manic Psychosis on a psychiatric intensive care unit
    Clinical Psychology & Psychotherapy, 2001
    Co-Authors: Ian B Kerr
    Abstract:

    A study of the efficacy of brief cognitive analytic therapy (CAT) with a series of patients (n = 4) with treatment-resistant Manic Psychosis on a psychiatric intensive care unit (PICU) was carried out. In one patient such an intervention proved redundant given an improved medication regime and subsequent willingness to comply with treatment. In a second, it proved impossible, in this context at least, due to fixed grandiose and paranoid delusions. In two others, however, this approach, particularly the technique of joint ‘reformulation’, appeared to be remarkably containing and effective with rapid subsidence of disturbed and non-compliant behaviour. Much of the ‘psychotic’ psychopathology of these patients became comprehensible within this model in terms of secondary, ‘self-state’ or narcissistic damage and enactment of maladaptive ‘procedures’ and ‘reciprocal roles’. Additionally, discussion of these procedures and the reciprocal roles elicited from and enacted by staff produced a marked change in attitude and behaviour by them. In one of these patients, improvement was such that transfer to an open ward was possible within a week and discharge soon after. Subsequent treatment was markedly more collaborative and enabling of good social function. It appears that CAT and its collaborative use of the ‘tools’ of reformulation could play an important role in the treatment of psychotic disorders in this and possibly other settings. Copyright © 2001 John Wiley & Sons, Ltd.

Ron Kikinis - One of the best experts on this subject based on the ideXlab platform.

  • Cavum septi pellucidi in first-episode schizophrenia and first-episode affective Psychosis: an MRI study
    Schizophrenia research, 2004
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Robert W. Mccarley, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Susan Demeo, Martha E. Shenton
    Abstract:

    A high prevalence of abnormal cavum septi pellucidi (CSP) in schizophrenia may reflect neurodevelopmental abnormalities in midline structures of the brain. The relationship, however, between abnormal CSP and clinical symptoms, and with abnormalities in other limbic structures remains unclear, as does the question of whether a similar abnormality is present in affective Psychosis. Seventy-four patients at their first hospitalization, 33 with schizophrenia and 41 with affective (mainly Manic) Psychosis, and 56 healthy control subjects underwent high-spatial-resolution magnetic resonance imaging (MRI). CSP on six slices or more on 0.9375-mm resampled coronal images was categorized as abnormal. The prevalence of abnormal CSP in both schizophrenic patients (26.1%) and affective Psychosis patients (18.2%) was significantly higher than was observed in control subjects (8.2%). In schizophrenic patients only, larger CSP was significantly associated with more severe thinking disturbance and smaller left parahippocampal gyrus gray matter volumes. While the relationships between CSP ratings and clinical symptoms did not significantly differ between the two Psychosis groups as assessed by the comparison of regression slopes, the association with limbic volumes appeared to be specific to schizophrenic patients. These results suggest that Psychosis associated with schizophrenia and affective disorder share, at least to some extent, neurodevelopmental abnormalities involving midline structures and associated psychopathological consequences. However, the association between abnormal CSP and limbic systems may be more specific to schizophrenia.

  • progressive decrease of left heschl gyrus and planum temporale gray matter volume in first episode schizophrenia a longitudinal magnetic resonance imaging study
    Archives of General Psychiatry, 2003
    Co-Authors: Kiyoto Kasai, Dean F. Salisbury, Martha E. Shenton, Yoshio Hirayasu, Ron Kikinis, Ferenc A. Jolesz, Toshiaki Onitsuka, Magdalena H Spencer, Deborah A Yurgeluntodd, Robert W. Mccarley
    Abstract:

    Background: The Heschl gyrus and planum temporale have crucial roles in auditory perception and language processing. Our previous investigation using magnetic resonance imaging (MRI) indicated smaller gray matter volumes bilaterally in the Heschl gyrus and in left planum temporale in patients with firstepisode schizophrenia but not in patients with firstepisode affective Psychosis. We sought to determine whether there are progressive decreases in anatomically defined MRI gray matter volumes of the Heschl gyrus and planum temporale in patients with firstepisode schizophrenia and also in patients with firstepisode affective Psychosis. Methods: At a private psychiatric hospital, we conducted a prospective high spatial resolution MRI study that included initial scans of 28 patients at their first hospitalization (13 with schizophrenia and 15 with affective Psychosis, 13 of whom had a Manic Psychosis) and 22 healthy control subjects. Follow-up scans occurred, on average, 1.5 years after the initial scan. Results: Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left Heschl gyrus (6.9%) and left planum temporale (7.2%) compared with patients with first-episode affective Psychosis or control subjects. Conclusions: These findings demonstrate a left-biased progressive volume reduction in the Heschl gyrus and planum temporale gray matter in patients with first-episode schizophrenia in contrast to patients with first-episode affective Psychosis and control subjects. Schizophrenia but not affective Psychosis seems to be characterized by a postonset progression of neocortical gray matter volume loss in the left superior temporal gyrus and thus may not be developmentally fixed. Arch Gen Psychiatry. 2003;60:766-775

  • Prefrontal Gray Matter Volume Reduction in First Episode Schizophrenia
    Cerebral cortex (New York N.Y. : 1991), 2001
    Co-Authors: Yoshio Hirayasu, Dean F. Salisbury, Martha E. Shenton, Shin Tanaka, Deborah A. Yurgelun-todd, Ron Kikinis, Massimo A. Desantis, James J. Levitt, Cynthia G. Wible, Ferenc A. Jolesz
    Abstract:

    Functional measures have consistently shown prefrontal abnormalities in schizophrenia. However, structural magnetic resonance imaging (MRI) findings of prefrontal volume reduction have been less consistent. In this study, we evaluated prefrontal gray matter volume in first episode (first hospitalized) patients diagnosed with schizophrenia, compared with first episode patients diagnosed with affective Psychosis and normal comparison subjects, to determine the presence in and specificity of prefrontal abnormalities to schizophrenia. Prefrontal gray and white matter volumes were measured from first episode patients with schizophrenia (n = 17), and from gender and parental socio-economic status-matched subjects with affective (mainly Manic) Psychosis (n = 17) and normal comparison subjects (n = 17), age-matched within a narrow age range (18--29 years). Total (left and right) prefrontal gray matter volume was significantly reduced in first episode schizophrenia compared with first episode affective Psychosis and comparison subjects. Follow-up analyses indicated significant left prefrontal gray matter volume reduction and trend level reduction on the right. Schizophrenia patients showed 9.2% reduction on the left and 7.7% reduction on the right compared with comparison subjects. White matter volumes did not differ among groups. These data suggest that prefrontal cortical gray matter volume reduction is selectively present at first hospitalization in schizophrenia but not affective Psychosis.

  • Planum Temporale and Heschl Gyrus Volume Reduction in Schizophrenia A Magnetic Resonance Imaging Study of First-Episode Patients
    Archives of general psychiatry, 2000
    Co-Authors: Yoshio Hirayasu, Dean F. Salisbury, Robert W. Mccarley, Shin Tanaka, Jun Soo Kwon, Melissa Frumin, Danielle Snyderman, Deborah A. Yurgelun-todd, Ron Kikinis, Ferenc A. Jolesz
    Abstract:

    Background: Magnetic resonance imaging studies in schizophrenia have revealed abnormalities in temporal lobe structures, including the superior temporal gyrus. More specifically, abnormalities have been reported in the posterior superior temporal gyrus, which includes the Heschl gyrus and planum temporale, the latter being an important substrate for language. However, the specificity of the Heschl gyrus and planum temporale structural abnormalities to schizophrenia vs affective Psychosis, and the possible confounding roles of chronic morbidity and neuroleptic treatment, remain unclear. Methods: Magnetic resonance images were acquired using a 1.5-T magnet from 20 first-episode (at first hospitalization) patients with schizophrenia (mean age, 27.3 years), 24 first-episode patients with Manic Psychosis (mean age, 23.6 years), and 22 controls (mean age, 24.5 years). There was no significant difference in age for the 3 groups. All brain images were uniformly aligned and then reformatted and resampled to yield isotropic voxels. Results: Gray matter volume of the left planum temporale differed among the 3 groups. The patients with schizophrenia had significantly smaller left planum temporale volume than controls (20.0%) and patients with mania (20.0%). Heschl gyrus gray matter volume (left and right) was also reduced in patients with schizophrenia compared with controls (13.1%) and patients with bipolar mania (16.8%). Conclusions: Compared with controls and patients with bipolar Manic Psychosis, patients with first-episode schizophrenia showed left planum temporale gray matter volume reduction and bilateral Heschl gyrus gray matter volume reduction. These findings are similar to those reported in patients with chronic schizophrenia and suggest that such abnormalities are present at first episode and are specific to schizophrenia.