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Q: What do people with schizophrenia, bipolar disorder, depression, addiction, obsessive-compulsive disorder, and anxiety have in common? A: A brain with similar gray-matter loss

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Dif­fer­ent men­tal dis­or­ders cause same brain-mat­ter loss, study finds (press release):

A meta-analy­sis of 193 brain-imag­ing stud­ies shows sim­i­lar gray-mat­ter loss in the brains of peo­ple with diag­noses as dif­fer­ent as schiz­o­phre­nia, depres­sion and addiction…The find­ings call into ques­tion a long­stand­ing ten­den­cy to dis­tin­guish psy­chi­atric dis­or­ders chiefly by their symp­toms rather than their under­ly­ing brain pathol­o­gy.

…pooled data from 193 sep­a­rate stud­ies con­tain­ing, in all, mag­net­ic-res­o­nance images of the brains of 7,381 patients falling into six diag­nos­tic cat­e­gories: schiz­o­phre­nia, bipo­lar dis­or­der, major depres­sion, addic­tion, obses­sive-com­pul­sive dis­or­der and a clus­ter of relat­ed anx­i­ety dis­or­ders. Com­par­ing the images with those from 8,511 healthy con­trol sub­jects, the research team iden­ti­fied three sep­a­rate brain struc­tures, sev­er­al cen­time­ters apart from one anoth­er, with a dimin­ished vol­ume of gray mat­ter, the brain tis­sue that serves to process infor­ma­tion. These struc­tures — the left and right ante­ri­or insu­la and the dor­sal ante­ri­or cin­gu­late — are known to be parts of a larg­er net­work in the brain whose com­po­nent parts tend to fire in syn­chrony. This net­work is asso­ci­at­ed with high­er-lev­el exec­u­tive func­tions such as con­cen­trat­ing in the face of dis­trac­tions, mul­ti­task­ing or task-switch­ing, plan­ning and deci­sion-mak­ing, and inhi­bi­tion of coun­ter­pro­duc­tive impuls­es.

Gray mat­ter loss in the three brain struc­tures was sim­i­lar across patients with dif­fer­ent psy­chi­atric con­di­tions, the researchers found.”

Study: Iden­ti­fi­ca­tion of a Com­mon Neu­ro­bi­o­log­i­cal Sub­strate for Men­tal Ill­ness (JAMA Psy­chi­a­try)

  • Impor­tance: Psy­chi­atric diag­noses are cur­rent­ly dis­tin­guished based on sets of spe­cif­ic symp­toms. How­ev­er, genet­ic and clin­i­cal analy­ses find sim­i­lar­i­ties across a wide vari­ety of diag­noses, sug­gest­ing that a com­mon neu­ro­bi­o­log­i­cal sub­strate may exist across men­tal ill­ness.
  • Main Out­comes and Mea­sures: We test­ed for areas of com­mon gray mat­ter vol­ume increase or decrease across Axis I diag­noses, as well as areas dif­fer­ing between diag­noses. Fol­low-up analy­ses on oth­er healthy par­tic­i­pant data sets test­ed con­nec­tiv­i­ty relat­ed to regions aris­ing from the meta-analy­sis and the rela­tion­ship of gray mat­ter vol­ume to cog­ni­tion.
  • Results: Based on the vox­el-based mor­phom­e­try meta-analy­sis of 193 stud­ies com­pris­ing 15?892 indi­vid­u­als across 6 diverse diag­nos­tic groups (schiz­o­phre­nia, bipo­lar dis­or­der, depres­sion, addic­tion, obses­sive-com­pul­sive dis­or­der, and anx­i­ety), we found that gray mat­ter loss con­verged across diag­noses in 3 regions: the dor­sal ante­ri­or cin­gu­late, right insu­la, and left insu­la. By con­trast, there were few diag­no­sis-spe­cif­ic effects, dis­tin­guish­ing only schiz­o­phre­nia and depres­sion from oth­er diag­noses…
  • Con­clu­sions and Rel­e­vance: We iden­ti­fied a con­cor­dance across psy­chi­atric diag­noses in terms of integri­ty of an ante­ri­or insula/dorsal ante­ri­or cingulate–based net­work, which may relate to exec­u­tive func­tion deficits observed across diag­noses. This con­cor­dance pro­vides an orga­niz­ing mod­el that empha­sizes the impor­tance of shared neur­al sub­strates across psy­chopathol­o­gy, despite like­ly diverse eti­olo­gies, which is cur­rent­ly not an explic­it com­po­nent of psy­chi­atric nosol­o­gy.

To learn more, check out this slid­edeck on the future of men­tal health and non-inva­sive neu­rotech­nol­o­gy:

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