Longitudinal volume changes of the pituitary gland in patients with schizotypal disorder and first-episode schizophrenia

• Published in: Progress in neuro-psychopharmacology & biological psychiatry 2011-01, Vol.35 (1), p.177-183
• Main Authors: Takahashi, Tsutomu, Zhou, Shi-Yu, Nakamura, Kazue, Tanino, Ryoichiro, Furuichi, Atsushi, Kido, Mikio, Kawasaki, Yasuhiro, Noguchi, Kyo, Seto, Hikaru, Kurachi, Masayoshi, Suzuki, Michio
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Analysis of Variance; Biological and medical sciences; Disease Progression; Female; Humans; Hypothalamic–pituitary–adrenal axis; Longitudinal Studies; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical sciences; Neuropharmacology; Personality disorders; Pharmacology. Drug treatments; Pituitary gland; Pituitary Gland - pathology; Pituitary Gland - physiopathology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Schizophrenia; Schizophrenia - pathology; Schizotypal disorder; Schizotypal Personality Disorder - pathology; Statistics as Topic; Young Adult
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2010.10.023

An enlarged volume of the pituitary gland has been reported in the schizophrenia spectrum, possibly reflecting the hypothalamic–pituitary–adrenal (HPA) hyperactivity. However, it remains largely unknown whether the pituitary size longitudinally changes in the course of the spectrum disorders. In the present study, longitudinal magnetic resonance imaging (MRI) data were obtained from 18 patients with first-episode schizophrenia, 13 patients with schizotypal disorder, and 20 healthy controls. The pituitary volume was measured at baseline and follow-up (mean, 2.7years) scans and was compared across groups. The pituitary volume was larger in the schizophrenia patients than controls at baseline, and both patient groups had significantly larger pituitary volume than controls at follow-up. In a longitudinal comparison, both schizophrenia (3.6%/year) and schizotypal (2.7%/year) patients showed significant pituitary enlargement compared with controls (−1.8%/year). In the schizophrenia patients, greater pituitary enlargement over time was associated with less improvement of delusions and higher scores for thought disorders at the follow-up. These findings suggest that the pituitary gland exhibits ongoing volume changes during the early course of the schizophrenia spectrum as a possible marker of state-related impairments. ► This MRI study examined the pituitary volume changes in schizophrenia spectrum. ► Both schizophrenia and schizotypal patients showed pituitary expansion over time. ► Greater pituitary expansion was associated with positive symptoms of schizophrenia. ► Pituitary volume may reflect state-related impairments in schizophrenia spectrum.