Structural brain abnormalities in schizophrenia in adverse environments: examining the effect of poverty and violence in six Latin American cities

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dc.contributor.authorCrossley, Nicolas
dc.contributor.authorZugman, Andre
dc.contributor.authorReyes, Francisco
dc.contributor.authorCzepielewski, Leticia
dc.contributor.authorCastro, Mariana
dc.contributor.authorDiaz, Ana
dc.contributor.authorPineda, Julian
dc.contributor.authorReckziegel, Ramiro
dc.contributor.authorGadelha, Ary
dc.contributor.authorJackowski, Andrea
dc.contributor.authorNoto, Cristiano
dc.contributor.authorAlliende, Luz
dc.contributor.authorIruretagoyena, Bárbara
dc.contributor.authorOssandon, Tomas
dc.contributor.authorRamírez, Juan
dc.contributor.authorCastañeda, Carmen
dc.contributor.authorGonzález, Alfonso
dc.contributor.authorNachar, Ruben
dc.contributor.authorLeón, Pablo
dc.contributor.authorUndurraga, Juan
dc.contributor.authorDe la Fuente, Camilo
dc.contributor.authorBressan, Rodrigo
dc.contributor.authorANDES Network
dc.date.accessioned2022-03-28T14:31:15Z
dc.date.available2022-03-28T14:31:15Z
dc.date.issued2021
dc.description.abstractBackground: 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- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.es
dc.description.versionVersión publicadaes
dc.identifier.citationCrossley NA, Zugman A, Reyes-Madrigal F, Czepielewski LS, Castro MN, Diaz-Zuluaga AM, Pineda-Zapata JA, Reckziegel R, Gadelha A, Jackowski A, Noto C, Alliende LM, Iruretagoyena B, Ossandon T, Ramirez-Mahaluf JP, Castañeda CP, Gonzalez-Valderrama A, Nachar R, León-Ortiz P, Undurraga J, López-Jaramillo C, Guinjoan SM, Gama CS, de la Fuente-Sandoval C, Bressan RA; ANDES Network. Structural brain abnormalities in schizophrenia in adverse environments: examining the effect of poverty and violence in six Latin American cities. Br J Psychiatry. 2021 Feb;218(2):112-118. doi: 10.1192/bjp.2020.143es
dc.identifier.urihttps://doi.org/10.1192/bjp.2020.143es
dc.identifier.urihttp://hdl.handle.net/11447/5819
dc.language.isoenes
dc.subjectSchizophreniaes
dc.subjectMagnetic resonancees
dc.subjectMagnetic resonance imaginges
dc.subjectGrey matteres
dc.subjectViolencees
dc.subjectPovertyes
dc.titleStructural brain abnormalities in schizophrenia in adverse environments: examining the effect of poverty and violence in six Latin American citieses
dc.typeArticlees
dcterms.sourceThe British journal of psychiatry : the journal of mental sciencees

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