Brijesh Kumar Soni1, Upendra Kumar Joish2, Hirdesh Sahni3, Raju A George4, Rajeev Sivasankar5, Rohit Aggarwal1. 1. Classified Specialist (Radiodiagnosis), Department of Radiology, Command Hospital Air Force , Bangalore, Karnataka, India . 2. Assistant Professor, Department of Radiology, JJM Medical College , Davangere, Bangalore, Karnataka, India . 3. Air Officer Commanding, 5 Air Force Hospital , Jorhat, Assam, India . 4. Head of Department and Senior Advisor (Radiodiagnosis), Department of Radiology, Command Hospital Air Force , Bangalore, Karnataka, India . 5. Senior Advisor and Interventional Neuroradiologist, Department of Radiology, Command Hospital Air Force , Bangalore, Karnataka, India .
Abstract
INTRODUCTION: The growing belief that endocrine abnormalities may underlie many mental conditions has led to increased use of imaging and hormonal assays in patients attending to psychiatric OPDs. People who are in an acute phase of a psychiatric disorder show Hypothalamic Pituitary Adrenal (HPA) axis hyperactivity, but the precise underlying central mechanisms are unclear. AIM: To assess the pituitary gland volume variations in patients presenting with new onset acute psychiatric illness in comparison with age and gender matched controls by using MRI. MATERIALS AND METHODS: The study included 50 patients, with symptoms of acute psychiatric illness presenting within one month of onset of illness and 50 age and gender matched healthy controls. Both patients and controls were made to undergo MRI of the Brain. A 0.9 mm slices of entire brain were obtained by 3 dimensional T1 weighted sequence. Pituitary gland was traced in all sagittal slices. Anterior pituitary and posterior pituitary bright spot were measured separately in each slice. Volume of the pituitary (in cubic centimetre- cm3) was calculated by summing areas. Significance of variations in pituitary gland volumes was compared between the cases and controls using Analysis of Covariance (ANOVA). RESULTS: There were significantly larger pituitary gland volumes in the cases than the controls, irrespective of psychiatric diagnosis (ANOVA, f=15.56; p=0.0002). Pituitary volumes in cases were 15.36% (0.73 cm3) higher than in controls. CONCLUSION: There is a strong likelihood of HPA axis overactivity during initial phase of all mental disorders along with increased pituitary gland volumes. Further studies including hormonal assays and correlation with imaging are likely to provide further insight into neuroanatomical and pathological basis of psychiatric disorders.
INTRODUCTION: The growing belief that endocrine abnormalities may underlie many mental conditions has led to increased use of imaging and hormonal assays in patients attending to psychiatric OPDs. People who are in an acute phase of a psychiatric disorder show Hypothalamic Pituitary Adrenal (HPA) axis hyperactivity, but the precise underlying central mechanisms are unclear. AIM: To assess the pituitary gland volume variations in patients presenting with new onset acute psychiatric illness in comparison with age and gender matched controls by using MRI. MATERIALS AND METHODS: The study included 50 patients, with symptoms of acute psychiatric illness presenting within one month of onset of illness and 50 age and gender matched healthy controls. Both patients and controls were made to undergo MRI of the Brain. A 0.9 mm slices of entire brain were obtained by 3 dimensional T1 weighted sequence. Pituitary gland was traced in all sagittal slices. Anterior pituitary and posterior pituitary bright spot were measured separately in each slice. Volume of the pituitary (in cubic centimetre- cm3) was calculated by summing areas. Significance of variations in pituitary gland volumes was compared between the cases and controls using Analysis of Covariance (ANOVA). RESULTS: There were significantly larger pituitary gland volumes in the cases than the controls, irrespective of psychiatric diagnosis (ANOVA, f=15.56; p=0.0002). Pituitary volumes in cases were 15.36% (0.73 cm3) higher than in controls. CONCLUSION: There is a strong likelihood of HPA axis overactivity during initial phase of all mental disorders along with increased pituitary gland volumes. Further studies including hormonal assays and correlation with imaging are likely to provide further insight into neuroanatomical and pathological basis of psychiatric disorders.
Authors: D A Axelson; P M Doraiswamy; O B Boyko; P Rodrigo Escalona; W M McDonald; J C Ritchie; L J Patterson; E H Ellinwood; C B Nemeroff; K R Krishnan Journal: Psychiatry Res Date: 1992-10 Impact factor: 3.222
Authors: R B Sassi; M Nicoletti; P Brambilla; K Harenski; A G Mallinger; E Frank; D J Kupfer; M S Keshavan; J C Soares Journal: Biol Psychiatry Date: 2001-08-15 Impact factor: 13.382
Authors: Carmine M Pariante; Konstantina Vassilopoulou; Dennis Velakoulis; Lisa Phillips; Bridget Soulsby; Stephen J Wood; Warrick Brewer; Deidre J Smith; Paola Dazzan; Alison R Yung; Ioannis M Zervas; George N Christodoulou; Robin Murray; Patrick D McGorry; Christos Pantelis Journal: Br J Psychiatry Date: 2004-07 Impact factor: 9.319