Cavum septum pellucidum and first-episode psychosis: A meta-analysis.
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ABSTRACT: Objectives
To investigate the prevalence and changes of cavum septum pellucidum (CSP) in first-episode psychosis (FEP) patients.Methods
Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify eligible studies comparing FEP patients and healthy controls from inception to Feb 29, 2016.Results
Ten cross-sectional studies and three longitudinal studies reported in ten articles met our criteria. Our meta-analysis found no significant differences in the prevalence of either "any CSP" (OR = 1.41; 95% CI 0.90-2.20; p = 0.13; I2 = 52.7%) or "large CSP" (OR = 1.10; 95% CI 0.77-1.58; p = 0.59; I2 = 24.1%) between FEP patients and healthy controls. However, the heterogeneity analysis of the prevalence of "any CSP" suggested bias in outcome reporting.Conclusions
The results based on current evidence suggest it is unclear whether "any CSP" is a risk factor for FEP due to the heterogeneity of the studies. There is insufficient evidence to support that "large CSP" is a possible risk factor for FEP.
SUBMITTER: Liu H
PROVIDER: S-EPMC5435239 | biostudies-literature | 2017
REPOSITORIES: biostudies-literature
Publications
Cavum septum pellucidum and first-episode psychosis: A meta-analysis.
Liu Hanwen H Li Ling L Shen Li L Wang Xianliang X Hou Yazhu Y Zhao Zhiqiang Z Gu Lili L Mao Jingyuan J
PloS one 20170517 5
<h4>Objectives</h4>To investigate the prevalence and changes of cavum septum pellucidum (CSP) in first-episode psychosis (FEP) patients.<h4>Methods</h4>Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify eligible studies comparing FEP patients and healthy controls from inception to Feb 29, 2016.<h4>Results</h4>Ten cross-sectional studies and three longitudinal studies reported in ten articles met our criteria. Our meta-analysis found no sig ...[more]
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Project description:Previous studies report that cavum septum pellucidum (CSP) is frequent among athletes with a history of repeated traumatic brain injury (TBI), such as boxers. Few studies of CSP in athletes, however, have assessed detailed features of the septum pellucidum in a case-control fashion. This is important because prevalence of CSP in the general population varies widely (2% to 85%) between studies. Further, rates of CSP among American pro-football players have not been described previously. We sought to characterize MRI features of the septum pellucidum in a series of retired pro-football players with a history of repeated concussive/subconcussive head traumas compared with controls. We retrospectively assessed retired American pro-football players presenting to our memory clinic with cognitive/behavioral symptoms in whom structural MRI was available with slice thickness ≤2 mm (n=17). Each player was matched to a memory clinic control patient with no history of TBI. Scans were interpreted by raters blinded to clinical information and TBI/football history, who measured CSP grade (0-absent, 1-equivocal, 2-mild, 3-moderate, 4-severe) and length according to a standard protocol. Sixteen of 17 (94%) players had a CSP graded ≥2 compared with 3 of 17 (18%) controls. CSP was significantly higher grade (p<0.001) and longer in players than controls (mean length±standard deviation: 10.6 mm±5.4 vs. 1.1 mm±1.3, p<0.001). Among patients presenting to a memory clinic, long high-grade CSP was more frequent in retired pro-football players compared with patients without a history of TBI.
| S-EPMC4696427 | biostudies-literature
Project description:Cavum septum pellucidum (CSP) is commonly observed upon neuroimaging examination in individuals exposed to repetitive head impacts (RHI) and post-mortem in cases with chronic traumatic encephalopathy. Consequently, CSP has been proposed as a potential biomarker for RHI-related neurodegeneration, yet prevalence estimates of CSP across other neurodegenerative diseases and its clinical implications are largely unknown. We assessed CSP prevalence and clinical correlates in individuals with RHI exposure, a history of traumatic brain injury (TBI), a neurodegenerative disease (i.e. Alzheimer's disease or frontotemporal dementia) and normal cognition. The primary group of interest, i.e. individuals exposed to RHI in contact sports or military service (n = 65; mean exposure 21.58 years), was compared against age- and sex-matched participants with TBI (n = 57; number of TBI range: 1-5) and non-exposed participants of the Amsterdam Dementia Cohort (Alzheimer's disease, n = 30; frontotemporal dementia, n = 24; normal cognition, n = 27). Structural 3D brain MRI scans were visually rated for CSP grade (ranging 0-4) by two raters blinded to the clinical information. A CSP of at least Grade 2 was considered enlarged/abnormal. Inter-rater reliability was assessed with Cohens' weighted Kappa (κ). We investigated whether prevalence of enlarged CSP differed between groups and assessed associations with neuropsychological outcomes (verbal memory, processing speed, mental flexibility and semantic fluency), neuropsychiatric symptoms (neuropsychiatric inventory), ventricular enlargement as measured with Evan's index and MRI volumes of composite regions (limbic, temporal-meta regions and the whole brain). Inter-rater reliability was substantial [κ = 0.734 (95% confidence interval 0.67-0.80)]. An enlarged CSP was more often observed in the RHI group (44.6%) compared with individuals with Alzheimer's disease [13.3%, odds ratio (OR) = 5.24 (1.79-19.26)], frontotemporal dementia [16.7%, OR = 4.03 (1.35-15.02)] and normal cognition [18.5%, OR = 3.54 (1.27-11.62)], all P FDR < 0.05, but not compared with the TBI group [29.8%, OR = 1.90 (0.90-4.06), P FDR = 0.094]. In those with RHI, enlarged CSP was associated with lower outcomes on verbal memory learning (η² = 0.09, P FDR = 0.023) and recall (η² = 0.08, P FDR = 0.030). For TBI, enlarged CSP was associated with lower performance on verbal memory learning; however, this lost significance after multiple comparison correction (η² = 0.014, P FDR = 0.09). Enlarged CSP was not associated with the composite MRI volumes, ventricular enlargement or neuropsychiatric symptoms. In summary, enlarged CSP was more prevalent in RHI-exposed individuals compared with individuals with a neurodegenerative disease or normal cognition, but not compared with TBI, and was associated with lower verbal memory performance in the RHI group. Our study highlights enlarged CSP as a potential consequence of long-term head impact exposure and, to a lesser extent, TBI, rather than a general consequence of neurodegeneration.
| S-EPMC11879415 | biostudies-literature
Project description:ImportanceMany studies have investigated the imaging findings showing sequelae of repetitive head trauma, with mixed results.ObjectiveTo determine whether fighters (boxers and mixed martial arts fighters) with cavum septum pellucidum (CSP) and cavum vergae (CV) have reduced volumes in various brain structures or worse clinical outcomes on cognitive and mood testing.Design, setting, and participantsThis cohort study assessed participants from the Professional Fighters Brain Health Study. Data were collected from April 14, 2011, to January 17, 2018, and were analyzed from September 1, 2018, to May 23, 2019. This study involved a referred sample of 476 active and retired professional fighters. Eligible participants were at least 18 years of age and had at least a fourth-grade reading level. Healthy age-matched controls with no history of trauma were also enrolled.ExposuresPresence of CSP, CV, and their total (additive) length (CSPV length).Main outcomes and measuresInformation regarding depression, impulsivity, and sleepiness among study participants was obtained using the Patient Health Questionnaire depression scale, Barrett Impulsiveness Scale, and the Epworth Sleepiness Scale. Cognition was assessed using raw scores from CNS Vital Signs. Volumes of various brain structures were measured via magnetic resonance imaging.ResultsA total of 476 fighters (440 men, 36 women; mean [SD] age, 30.0 [8.2] years [range, 18-72 years]) and 63 control participants (57 men, 6 women; mean [SD] age, 30.8 [9.6] years [range, 18-58 years]) were enrolled in the study. Compared with fighters without CV, fighters with CV had significantly lower mean psychomotor speed (estimated difference, -11.3; 95% CI, -17.4 to -5.2; P = .004) and lower mean volumes in the supratentorium (estimated difference, -31 191 mm3; 95% CI, -61 903 to -479 mm3; P = .05) and other structures. Longer CSPV length was associated with lower processing speed (slope, -0.39; 95% CI, -0.49 to -0.28; P < .001), psychomotor speed (slope, -0.43; 95% CI, -0.53 to -0.32; P < .001), and lower brain volumes in the supratentorium (slope, -1072 mm3 for every 1-mm increase in CSPV length; 95% CI, -1655 to -489 mm3; P < .001) and other structures.Conclusions and relevanceThis study suggests that the presence of CSP and CV is associated with lower regional brain volumes and cognitive performance in a cohort exposed to repetitive head trauma.
| S-EPMC6735412 | biostudies-literature
Project description:ObjectiveAdolescent-onset exposure to highly addictive substances such as opiates may induce far-reaching deleterious effects on later mental and physical health. However, little is known about the neurodevelopmental basis for adolescent-onset opiate dependence. Here we examined whether having an abnormally large cavum septum pellucidum (CSP), a putative marker of limbic structural maldevelopment, is associated with opiate dependence particularly beginning in adolescence.MethodThe overall length of the CSP and the prevalence of abnormal enlargement of the CSP were assessed and compared in 65 opiate-dependent subjects (41 adolescent-onset opiate users and 24 adult-onset opiate users) and 67 healthy subjects.ResultsOpiate-dependent subjects showed a greater prevalence of abnormal CSP enlargement relative to healthy subjects (odds ratio [OR]=3.64, p=0.034). The overall CSP length of adolescent-onset opiate-dependent subjects was greater, as compared not only with healthy subjects (F?,???=11.03, p=0.001) but also with those who began opiate use during adulthood (F?,??=4.43, p=0.039).ConclusionsThe current findings provide the first evidence that abnormal CSP enlargement, which reflects limbic system dysgenesis of neurodevelopmental origin, may be linked to later development of opiate dependence. In addition, a greater CSP length, which indicates more severe limbic abnormalities, appears to confer higher risk for earlier onset of opiate use.
| S-EPMC3813473 | biostudies-literature
Project description:BackgroundCavum septum pellucidum (CSP) and cavum vergae (CV) are normal anatomical variations present in some children, adolescents, and adults. When the cavity is larger than normal, it is called a cyst. Symptomatic cases of CSP and CV cyst are rare, and the clinical presentation is varied. A case with multiple nerve involvement is described.Case descriptionA healthy 17-year-old female presented a sudden headache, right cervicobrachialgia, right ptosis, visual changes, and left facial paralysis over 10 days. Head magnetic resonance imaging revealed CSP and CV cyst. Inflammation, infection, and vascular disorders were ruled out. We decided to perform a right transfrontal endoscopic intraventricular septostomy and a right Monro foraminoplasty, which were successful. One month after surgery, the patient had no more signs or symptoms. She has remained asymptomatic for the past year.ConclusionMultiple nerve involvement was directly related to CSP and CV cyst. The cyst bilaterally occluded the foramen of Monro causing intracranial hypertension. It was possible to obtain complete resolution of the clinical features through neuroendoscopic fenestration and foraminoplasty.
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Project description:BackgroundValidity of current International Classification of Disease/Diagnostic and Statistical Manual of Mental Disorders (ICD/DSM) first episode psychosis diagnoses is essential in clinical practice, research, training and public health.MethodWe provide a meta-analytical estimate of prospective diagnostic stability and instability in ICD-10 or DSM-IV first episode diagnoses of functional psychoses. Independent extraction by multiple observers. Random effect meta-analysis conducted with the "metaprop," "metaninf," "metafunnel," "metabias," and "metareg" packages of STATA13.1. Moderators were tested with meta-regression analyses. Heterogeneity was assessed with the I 2 index. Sensitivity analyses tested robustness of results. Publication biases were assessed with funnel plots and Egger's test.Findings42 studies and 45 samples were included, for a total of 14 484 first episode patients and an average follow-up of 4.5 years. Prospective diagnostic stability ranked: schizophrenia 0.90 (95% CI 0.85-0.95), affective spectrum psychoses 0.84 (95% CI 0.79-0.89), schizoaffective disorder 0.72 (95% CI 0.61-0.73), substance-induced psychotic disorder 0.66 (95% CI 0.51-0.81), delusional disorder 0.59 (95% CI 0.47-0.71), acute and transient psychotic disorder/brief psychotic disorder 0.56 (95% CI 0.62-0.60), psychosis not otherwise specified 0.36 (95% CI 0.27-0.45, schizophreniform disorder 0.29 (95% CI 0.22-0.38). Diagnostic stability within schizophrenia spectrum psychoses was 0.93 (95% CI 0.89-0.97); changes to affective spectrum psychoses were 0.05 (95% CI 0.01-0.08). About 0.10 (95% CI 0.05-0.15) of affective spectrum psychoses changed to schizophrenia spectrum psychosis. Across the other psychotic diagnoses there was high diagnostic instability, mostly to schizophrenia.InterpretationThere is meta-analytical evidence for high prospective diagnostic stability in schizophrenia spectrum and affective spectrum psychoses, with no significant ICD/DSM differences. These results may inform the development of new treatment guidelines for early psychosis and impact drug licensing from regulatory agencies.
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Project description:BackgroundEarly detection of central nervous system (CNS) anomalies in human embryos through prenatal screening is crucial for timely intervention and improved patient outcomes. Fetal brain mid-sagittal ultrasound images (FBMUIs) play a pivotal role as a diagnostic tool for detecting structural abnormalities. However, the automatic localization and quantitative segmentation of complex anatomical structures such as the corpus callosum-cavum septum pellucidum complex (CCC) and cerebellar vermis (CV) in FBMUIs present significant challenges.MethodsTo address this issue, we propose an integrated framework that combines anatomical knowledge with computer vision techniques. Our framework comprises four steps: (I) generation of average templates for CCC and CV local images using a variational autoencoder (VAE); (II) localizing the CCC by using the "Initial Localization-Accurate Localization-Result Detection" strategy, followed by segmenting it based on morphological characteristics using the "Initial Contour Fitting-Contour Iteration" strategy; (III) applying a similar strategy as CCC localization and CV segmentation; and (IV) leveraging spatial and morphological characteristics to achieve accurate localization and segmentation.ResultsOur CCC and CV localization and segmentation methods were validated by using 140 FBMUIs from various perspectives. The accuracy and effectiveness of our approach were demonstrated through data statistics and comparative analysis. Currently, clinical trials are being conducted on our method at Shengjing Hospital of China Medical University.ConclusionsOur proposed integrated framework presents a novel solution for the automatic localization and quantitative segmentation of the CCC and CV in FBMUIs. It shows promise for early diagnosis of CNS anomalies in human embryos, offering significant clinical implications.
| S-EPMC10498265 | biostudies-literature
Project description:ImportanceIndividuals presenting with first-episode psychosis (FEP) may have a secondary ("organic") etiology to their symptoms that can be identified using neuroimaging. Because failure to detect such cases at an early stage can have serious clinical consequences, it has been suggested that brain magnetic resonance imaging (MRI) should be mandatory for all patients presenting with FEP. However, this remains a controversial issue, partly because the prevalence of clinically relevant MRI abnormalities in this group is unclear.ObjectiveTo derive a meta-analytic estimate of the prevalence of clinically relevant neuroradiological abnormalities in FEP.Data sourcesElectronic databases Ovid, MEDLINE, PubMed, Embase, PsychINFO, and Global Health were searched up to July 2021. References and citations of included articles and review articles were also searched.Study selectionMagnetic resonance imaging studies of patients with FEP were included if they reported the frequency of intracranial radiological abnormalities.Data extraction and synthesisIndependent extraction was undertaken by 3 researchers and a random-effects meta-analysis of pooled proportions was calculated. Moderators were tested using subgroup and meta-regression analyses. Heterogeneity was evaluated using the I2 index. The robustness of results was evaluated using sensitivity analyses. Publication bias was assessed using funnel plots and Egger tests.Main outcomes and measuresProportion of patients with a clinically relevant radiological abnormality (defined as a change in clinical management or diagnosis); number of patients needed to scan to detect 1 such abnormality (number needed to assess [NNA]).ResultsTwelve independent studies (13 samples) comprising 1613 patients with FEP were included. Of these patients, 26.4% (95% CI, 16.3%-37.9%; NNA of 4) had an intracranial radiological abnormality, and 5.9% (95% CI, 3.2%-9.0%) had a clinically relevant abnormality, yielding an NNA of 18. There were high degrees of heterogeneity among the studies for these outcomes, 95% to 73%, respectively. The most common type of clinically relevant finding was white matter abnormalities, with a prevalence of 0.9% (95% CI, 0%-2.8%), followed by cysts, with a prevalence of 0.5% (95% CI, 0%-1.4%).Conclusions and relevanceThis systematic review and meta-analysis found that 5.9% of patients presenting with a first episode of psychosis had a clinically relevant finding on MRI. Because the consequences of not detecting these abnormalities can be serious, these findings support the use of MRI as part of the initial clinical assessment of all patients with FEP.
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Project description:Despite mixed findings, increasing evidence suggests that people with first-episode psychosis (FEP) show increased pro-inflammatory and pro-oxidative status. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to conduct a systematic literature search of cross-sectional studies comparing in vivo inflammatory and oxidative blood markers between FEP patients and healthy controls. We analyzed 61 independent samples from 59 publications, including 3002 patients with FEP (ie, patients with FEP, early psychosis, first-episode schizophrenia or early schizophrenia) and 2806 controls. After controlling for multiple comparisons, our meta-analysis showed that total antioxidant status and docosahexaenoic acid levels were significantly lower in FEP patients than in controls, whereas levels of homocysteine, interleukin-6 and tumor necrosis factor alpha were significantly higher in FEP patients than in controls. This suggests that FEP patients had reduced antioxidant status and a pro-inflammatory imbalance, and that these biological processes may be targets for managing FEP.
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Project description:Genome-wide patterns of DNA methylation were quantified using the Illumina Infinium HumanMethylationEPIC BeadChip (“EPIC array”) in DNA samples isolated from blood for schizophrenia cases, first episode psychosis patients and controls. These samples were profiled as part of a wider study where they were meta-analysed with other cohorts.
2021-04-07 | GSE152026 | GEO