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Common gray matter loss in the frontal cortex in patients with methamphetamine-associated psychosis and schizophrenia
Xiaojian Jia1, Jianhong Wang1, Wentao Jiang1
1Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen Clinical Research Center for Mental Disorders, Shenzhen 518020, China.
Background And Hypothesis:
Methamphetamine (MA)-associated psychosis has become a public concern. However, its mechanism is not clear. Investigating similarities and differences between MA-associated psychosis and schizophrenia in brain alterations would be informative for neuropathology.
Study Design:
This study compared gray matter volumes of the brain across four participant groups: healthy controls (HC, n = 53), MA users without psychosis (MA, n = 22), patients with MA-associated psychosis (MAP, n = 34) and patients with schizophrenia (SCZ, n = 33). Clinical predictors of brain alterations, as well as association of brain alterations with psychotic symptoms and attention impairment were further investigated.
Study Results:
Compared with the HC, the MAP and the SCZ showed similar gray matter reductions in the frontal cortex, particularly in prefrontal areas. Moreover, a stepwise extension of gray matter reductions was exhibited across the MA - MAP - SCZ. Duration of abstinence was associated with regional volumetric recovery in the MAP, while this amendment in brain morphometry was not accompanied with symptom's remission. Illness duration of psychosis was among the predictive factors of regional gray matter reductions in both psychotic groups. Volume reductions were found to be associated with attention impairment in the SCZ, while this association was reversed in the MAP in frontal cortex.
Conclusions:
This study suggested MA-associated psychosis and schizophrenia had common neuropathology in cognitive-related frontal cortices. A continuum of neuropathology between MA use and schizophrenia was tentatively implicated. Illness progressions and glial repairments could both play roles in neuropathological changes in MA-associated psychosis.
Insights
Methamphetamine-associated psychosis and schizophrenia share similar brain gray matter reductions in frontal regions. A continuum of brain changes may exist between methamphetamine use and schizophrenia, suggesting shared neuropathology.
Area of Science:
- Neuroscience
- Psychiatry
- Neuroimaging
Background:
- Methamphetamine (MA)-associated psychosis (MAP) is a growing public health concern with unclear mechanisms.
- Understanding MAP's neuropathology by comparing it to schizophrenia (SCZ) can illuminate shared and distinct brain alterations.
Purpose of the Study:
- To compare gray matter volumes in the brains of healthy controls (HC), MA users without psychosis (MA), MAP patients, and SCZ patients.
- To investigate clinical predictors of brain alterations and their association with psychotic symptoms and attention deficits.
Main Methods:
- Gray matter volumes were analyzed using neuroimaging techniques across four groups: HC (n=53), MA (n=22), MAP (n=34), and SCZ (n=33).
- Statistical analyses examined group differences, clinical predictors, and correlations between brain alterations and clinical symptoms.
Main Results:
- MAP and SCZ groups exhibited similar gray matter reductions in the frontal cortex, especially prefrontal areas, compared to HC.
- A stepwise progression of gray matter reduction was observed from MA users to MAP patients to SCZ patients.
- While abstinence duration correlated with some volumetric recovery in MAP, it did not coincide with symptom remission. Illness duration predicted gray matter reduction in both MAP and SCZ groups.
- Attention impairment showed an inverse association with frontal cortex volume in MAP compared to SCZ.
Conclusions:
- MAP and SCZ share common neuropathological features in frontal cortices, suggesting overlapping mechanisms.
- A potential continuum of neuropathology exists between MA use and schizophrenia.
- Illness progression and glial repair processes may contribute to neuropathological changes in MAP.
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