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Title: Increased cortical thickness in nodes of the cognitive control and default mode networks in psychosis of epilepsy.
Austin Authors: Allebone, James;Wilson, Sarah J;Bradlow, Richard C J;Maller, Jerome;O'Brien, Terry;Mullen, Saul A ;Cook, Mark;Adams, Sophia J;Vogrin, Simon;Vaughan, David N;Connelly, Alan;Kwan, Patrick;Berkovic, Samuel F ;D'Souza, Wendyl J;Jackson, Graeme D ;Velakoulis, Dennis;Kanaan, Richard A A 
Affiliation: Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
Department of Neuroscience, Alfred Hospital, Monash University, Melbourne, Australia
Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Turning Point, Eastern Health, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health
Graeme Clark Institute, University of Melbourne, Melbourne, Australia
Psychiatry (University of Melbourne)
St Vincent's Hospital, Melbourne, Victoria, Australia
Comprehensive Epilepsy Program
Department of Medicine, St Vincent's Hospital, The University of Melbourne, Australia
ANU College of Health and Medicine, Australian National University, Canberra, Victoria, Australia
Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Melbourne, Australia
Melbourne School of Psychological Sciences, University of Melbourne, VIC, Australia
Royal Melbourne Hospital, Melbourne, Victoria, Australia
Issue Date: Oct-2022
Date: 2022
Publication information: Seizure 2022; 101: 244-252
Abstract: To explore the cortical morphological associations of the psychoses of epilepsy. Psychosis of epilepsy (POE) has two main subtypes - postictal psychosis and interictal psychosis. We used automated surface-based analysis of magnetic resonance images to compare cortical thickness, area, and volume across the whole brain between: (i) all patients with POE (n = 23) relative to epilepsy-without psychosis controls (EC; n = 23), (ii) patients with interictal psychosis (n = 10) or postictal psychosis (n = 13) relative to EC, and (iii) patients with postictal psychosis (n = 13) relative to patients with interictal psychosis (n = 10). POE is characterised by cortical thickening relative to EC, occurring primarily in nodes of the cognitive control network; (rostral anterior cingulate, caudal anterior cingulate, middle frontal gyrus), and the default mode network (posterior cingulate, medial paracentral gyrus, and precuneus). Patients with interictal psychosis displayed cortical thickening in the left hemisphere in occipital and temporal regions relative to EC (lateral occipital cortex, lingual, fusiform, and inferior temporal gyri), which was evident to a lesser extent in postictal psychosis patients. There were no significant differences in cortical thickness, area, or volume between the postictal psychosis and EC groups, or between the postictal psychosis and interictal psychosis groups. However, prior to correction for multiple comparisons, both the interictal psychosis and postictal psychosis groups displayed cortical thickening relative to EC in highly similar regions to those identified in the POE group overall. The results show cortical thickening in POE overall, primarily in nodes of the cognitive control and default mode networks, compared to patients with epilepsy without psychosis. Additional thickening in temporal and occipital neocortex implicated in the dorsal and ventral visual pathways may differentiate interictal psychosis from postictal psychosis. A novel mechanism for cortical thickening in POE is proposed whereby normal synaptic pruning processes are interrupted by seizure onset.
DOI: 10.1016/j.seizure.2022.09.006
Journal: Seizure
PubMed URL: 36116283
Type: Journal Article
Subjects: Cortex
Interictal psychosis
Postictal psychosis
Appears in Collections:Journal articles

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