Difficulties during delivery brain ventricle enlargement and cognitive impairment in first episode psychosis

Background: Patients with a first episode of psychosis (FEP) display clinical, cognitive, and structural brain abnormalities at illness onset. Ventricular enlargement has been identified in schizophrenia since the initial development of neuroimaging techniques. Obstetric abnormalities have been asso...

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Bibliographic Details
Authors: Costas Carrera, Ana, Verdolini, Norma, García Rizo, Clemente, Mezquida Mateos, Gisela, Janssen, Joost, Valli, Isabel, Corripio, Iluminada, Sánchez-Torres, Ana M, Bioque Alcázar, Miquel, Lobo, Antonio, González-Pinto, Ana, Rapado Castro, Marta, Vieta i Pascual, Eduard, 1963-, Serna, Elena de la, 1978-, Mané Santacana, Anna, Roldán, Alexandra, Crossley, Nicolas, Penadés Rubio, Rafael, Cuesta, Manuel J., Parellada, Mara, Bernardo Arroyo, Miquel, PEPs group
Format: article
Status:Published version
Publication Date:2023
Country:España
Institution:Universidad de Barcelona
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/219604
Online Access:https://hdl.handle.net/2445/219604
Access Level:Open access
Keyword:Psicosi
Complicacions en el part
Esquizofrènia
Ventricles cardíacs
Trastorns de la cognició
Psychoses
Labor complications (Obstetrics)
Schizophrenia
Ventricle of heart
Cognition disorders
Description
Summary:Background: Patients with a first episode of psychosis (FEP) display clinical, cognitive, and structural brain abnormalities at illness onset. Ventricular enlargement has been identified in schizophrenia since the initial development of neuroimaging techniques. Obstetric abnormalities have been associated with an increased risk of developing psychosis but also with cognitive impairment and brain structure abnormalities. Difficulties during delivery are associated with a higher risk of birth asphyxia leading to brain structural abnormalities, such as ventriculomegaly, which has been related to cognitive disturbances. Methods: We examined differences in ventricular size between 142 FEP patients and 123 healthy control participants using magnetic resonance imaging. Obstetric complications were evaluated using the Lewis-Murray scale. We examined the impact of obstetric difficulties during delivery on ventricle size as well as the possible relationship between ventricle size and cognitive impairment in both groups. Results: FEP patients displayed significantly larger third ventricle size compared with healthy controls. Third ventricle enlargement was associated with diagnosis (higher volume in patients), with difficulties during delivery (higher volume in subjects with difficulties), and was highest in patients with difficulties during delivery. Verbal memory was significantly associated with third ventricle to brain ratio. Conclusions: Our results suggest that difficulties during delivery might be significant contributors to the ventricular enlargement historically described in schizophrenia. Thus, obstetric complications may contribute to the development of psychosis through changes in brain architecture.