Brain volume in male patients with recent onset schizophrenia with and without cannabis use disorders

Laura Koenders, Marise W J Machielsen, F J van der Meer, Angelique C M van Gasselt, Carin J Meijer, Wim van den Brink, Maarten W J Koeter, Matthan W A Caan, Janna Cousijn, Anouk den Braber, Dennis van 't Ent, Maaike M Rive, Aart H Schene, Elsmarieke van de Giessen, Chaim Huyser, Bart P de Kwaasteniet, Dick J Veltman, Lieuwe de Haan

Research output: Contribution to journalArticleAcademicpeer-review

20 Citations (Scopus)


BACKGROUND: Schizophrenia is highly comorbid with cannabis use disorders (CUDs), and this comorbidity is associated with an unfavourable course. Early onset or frequent cannabis use may influence brain structure. A key question is whether comorbid CUDs modulate brain morphology alterations associated with schizophrenia.

METHODS: We used surface-based analysis to measure the brain volume, cortical thickness and cortical surface area of a priori-defined brain regions (hippocampus, amygdala, thalamus, caudate, putamen, orbitofrontal cortex, anterior cingulate cortex, insula, parahippocampus and fusiform gyrus) in male patients with schizophrenia or related disorders with and without comorbid CUDs and matched healthy controls. Associations between age at onset and frequency of cannabis use with regional grey matter volume were explored.

RESULTS: We included 113 patients with (CUD, n = 80) and without (NCUD, n = 33) CUDs and 84 controls in our study. As expected, patients with schizophrenia (with or without a CUD) had smaller volumes of most brain regions (amygdala, putamen, insula, parahippocampus and fusiform gyrus) than healthy controls, and differences in cortical volume were mainly driven by cortical thinning. Compared with the NCUD group, the CUD group had a larger volume of the putamen, possibly driven by polysubstance use. No associations between age at onset and frequency of use with regional grey matter volumes were found.

LIMITATIONS: We were unable to correct for possible confounding effects of smoking or antipsychotic medication.

CONCLUSION: Patients with psychotic disorders and comorbid CUDs have larger putamen volumes than those without CUDs. Future studies should elaborate whether a large putamen represents a risk factor for the development of CUDs or whether (poly)substance use causes changes in putamen volume.

Original languageEnglish
Pages (from-to)197-206
Number of pages10
JournalJournal of Psychiatry & Neuroscience
Issue number3
Publication statusPublished - May 2015


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