TY - JOUR
T1 - Structural brain abnormalities in schizophrenia in adverse environments
T2 - Examining the effect of poverty and violence in six Latin American cities
AU - Crossley, Nicolas A.
AU - Zugman, Andre
AU - Reyes-Madrigal, Francisco
AU - Czepielewski, Leticia S.
AU - Castro, Mariana N.
AU - Diaz-Zuluaga, Ana M.
AU - Pineda-Zapata, Julian A.
AU - Reckziegel, Ramiro
AU - Gadelha, Ary
AU - Jackowski, Andrea
AU - Noto, Cristiano
AU - Alliende, Luz M.
AU - Iruretagoyena, Barbara
AU - Ossandon, Tomas
AU - Ramirez-Mahaluf, Juan P.
AU - Castañeda, Carmen P.
AU - Gonzalez-Valderrama, Alfonso
AU - Nachar, Ruben
AU - León-Ortiz, Pablo
AU - Undurraga, Juan
AU - López-Jaramillo, Carlos
AU - Guinjoan, Salvador M.
AU - Gama, Clarissa S.
AU - De La Fuente-Sandoval, Camilo
AU - Bressan, Rodrigo A.
N1 - Funding Information:
This collaboration was made possible thanks to the Programa Iberoamericano de Ciencia y Tecnología para el Desarrollo CYTED Redes to the ANDES Network (grant 218RT0547). Funding from individual studies came from different grants. Brazil: Grants Produtividade em Pesquisa from conselho nacional de desenvolvimento científico e tecnológico (CNPq) PQ-CNPq 304587/2018-4, CNPq Universal 470326/2011-5, Fundação de Amparo à pesquisa do Estado do Rio Grande do Sul (FAPERGS) 17/2551-0001 and 1009340-06/2010, FAPERGS/ CNPq PRONEM 11/2057-2 (to C.S.G.); Pós-doutorado junior CNPq 153081/2018-0 (to L.S.C.). Chile: Comisión Nacional de Investigación Científica y Tecnológica (CONICYT) National Fund for the Development of Science and Technology (FONDECYT) regular 1160736 (to N.A.C.) and 1180358 (to J.U.), CONICYT Associative Research Program (PIA) ACT1414 and ACT192064. Colombia: COLCIENCIAS call 990 (3 August 2017), Code 111577757629, Contract 781 de from 2017, PRISMA U.T (to C.L.-J.). Mexico: Consejo Nacional de Ciencia y Tecnología (CONACyT), projects182279 and 261895 (to C.F.-S.), and CONACyT’s Sistema Nacional de Investigadores (to P.L.O. and C.F.-S.). None of these funding agencies had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication.
Publisher Copyright:
© 2020 The Author(s). Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Summary Background Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear. Aims We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed. Method This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model. Results A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R =-0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure. Conclusions Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- A nd middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.
AB - Summary Background Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear. Aims We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed. Method This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model. Results A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R =-0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure. Conclusions Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- A nd middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.
KW - grey matter
KW - magnetic resonance imaging
KW - poverty
KW - Schizophrenia
KW - violence
UR - http://www.scopus.com/inward/record.url?scp=85100051915&partnerID=8YFLogxK
U2 - 10.1192/bjp.2020.143
DO - 10.1192/bjp.2020.143
M3 - Article
C2 - 32807243
AN - SCOPUS:85100051915
SN - 0007-1250
VL - 218
SP - 112
EP - 118
JO - British Journal of Psychiatry
JF - British Journal of Psychiatry
IS - 2
ER -