The relationship between stress, HPA axis functioning and brain structure in first episode psychosis over the first 12 weeks of treatment

Reniers, Renate L.E.P., Garner, Belinda, Phassouliotis, Christina, Phillips, Lisa J., Markulev, Connie, Pantelis, Christos, Bendall, Sarah, McGorry, Patrick D., & Wood, Stephen J. (2015) The relationship between stress, HPA axis functioning and brain structure in first episode psychosis over the first 12 weeks of treatment. Psychiatry Research: Neuroimaging, 231(2), pp. 111-119.

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Abstract

Stress and abnormal hypothalamic-pituitary-adrenal axis functioning have been implicated in the early phase of psychosis and may partly explain reported changes in brain structure. This study used magnetic resonance imaging to investigate whether biological measures of stress were related to brain structure at baseline and to structural changes over the first 12 weeks of treatment in first episode patients (n=22) compared with matched healthy controls (n=22). At baseline, no significant group differences in biological measures of stress, cortical thickness or hippocampal volume were observed, but a significantly stronger relationship between baseline levels of cortisol and smaller white matter volumes of the cuneus and anterior cingulate was found in patients compared with controls. Over the first 12 weeks of treatment, patients showed a significant reduction in thickness of the posterior cingulate compared with controls. Patients also showed a significant positive relationship between baseline cortisol and increases in hippocampal volume over time, suggestive of brain swelling in association with psychotic exacerbation, while no such relationship was observed in controls. The current findings provide some support for the involvement of stress mechanisms in the pathophysiology of early psychosis, but the changes are subtle and warrant further investigation.

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ID Code: 84451
Item Type: Journal Article
Refereed: Yes
Keywords: first episode psychosis, stress, HPA axis, cortical thickness, hippocampal volume, white matter volume
DOI: 10.1016/j.pscychresns.2014.11.004
ISSN: 0925-4927
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Psychiatry (incl. Psychotherapy) (110319)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NEUROSCIENCES (110900) > Neurosciences not elsewhere classified (110999)
Divisions: Current > Schools > School of Clinical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Funding:
Copyright Owner: Copyright 2015 Elsevier
Copyright Statement: This is the author’s version of a work that was accepted for publication in Psychiatry Research: Neuroimaging. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Psychiatry Research: Neuroimaging, [VOL 231, ISSUE 2, (2015)] DOI: 10.1016/j.pscychresns.2014.11.004
Deposited On: 25 May 2015 22:57
Last Modified: 03 Jun 2015 04:11

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