Cigarette smoking is associated with thinner cingulate and insular cortices in patients with severe mental illness

Background Magnetic resonance imaging (MRI) studies show reduced cortical thickness in patients with schizophrenia and bipolar disorder. These subtle brain abnormalities may provide insight into illness mechanisms. However, environmental and lifestyle-related factors, such as cigarette smoking, may...

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Bibliographic Details
Published in:Journal of psychiatry & neuroscience 2015-07, Vol.40 (4), p.241-249
Main Authors: Jørgensen, Kjetil Nordbø, MPhil, Skjærvø, Ingeborg, MD, PhD, Mørch-Johnsen, Lynn, MD, Haukvik, Unn Kristin, MD, PhD, Lange, Elisabeth Heffermehl, MD, PhD, Agartz, Ingrid, Melle, Ingrid, MD, PhD, Andreassen, Ole Andreas, Psychol, Cand, MD
Format: Article
Language:English
Subjects:
Adult
Aging - pathology
Alcohol
Anniversaries
Bipolar disorder
Bipolar Disorder - complications
Bipolar Disorder - pathology
Brain research
Cerebral Cortex - pathology
Cigarettes
Cingulate cortex
Complications and side effects
Drug use
Female
Health aspects
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Medical Education
Mental disorders
Mentally ill
Organ Size
Patients
Physiological aspects
Psychiatric Status Rating Scales
Psychiatry
Psychosis
Psychotic Disorders - complications
Psychotic Disorders - pathology
Regions
Research Paper
Schizophrenia
Schizophrenia - complications
Schizophrenia - pathology
Severity of Illness Index
Smoking
Smoking - pathology
Tobacco Use Disorder - complications
Tobacco Use Disorder - pathology
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Summary:Background Magnetic resonance imaging (MRI) studies show reduced cortical thickness in patients with schizophrenia and bipolar disorder. These subtle brain abnormalities may provide insight into illness mechanisms. However, environmental and lifestyle-related factors, such as cigarette smoking, may contribute to brain structure changes. Cigarette smoking is highly prevalent in patients with severe mental illness. In nonpsychiatric samples, smoking has been associated with reduced thickness in the anterior (ACC) and posterior cingulate cortices, the insular cortex (INS), the dorsolateral prefrontal cortex and the orbitofrontal cortex. Methods We examined MRI scans from patients with schizophrenia, other psychotic disorders or bipolar disorder and healthy controls using FreeSurfer. Results We included 506 patients (49% smokers) and 237 controls (20% smokers) in our study. We found reduced cortical thickness in the left rostral ACC and the left INS in smoking patients compared with nonsmoking patients, but this difference was not found among healthy controls. No dose–response relationship was found between amount of smoking and cortical thickness in these regions. Among patients, maps of thickness along the whole cortical surface revealed reduced insular thickness but no effects in other regions. Among healthy controls, similar analyses revealed increased age-related cortical thinning in the left occipital lobe among smokers compared with nonsmokers. Limitations The causal direction could not be determined owing to the cross-sectional design and lack of detailed data on smoking addiction and smoking history. Conclusion The effect of cigarette smoking should be considered in MRI studies of patients with severe mental illness.
ISSN:1180-4882
1488-2434
DOI:10.1503/jpn.140163